Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2021; 27(38): 6465-6475
Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6465
Magnetic resonance imaging-radiomics evaluation of response to chemotherapy for synchronous liver metastasis of colorectal cancer
Yan-Qing Ma, Yang Wen, Hong Liang, Jian-Guo Zhong, Pei-Pei Pang
Yan-Qing Ma, Yang Wen, Jian-Guo Zhong, Department of Radiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
Hong Liang, Department of Radiology, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
Pei-Pei Pang, Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou 310000, Zhejiang Province, China
Author contributions: Ma YQ designed the retrospective study and wrote the original article; Wen Y directed and coordinated the study; Zhong JG and Liang H performed a part of the study; Pang PP analyzed the data; All authors have read and approve the final manuscript.
Supported by The fund of Medical and Health Research Projects of Health Commission of Zhejiang Province, No. 2019KY035.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Zhejiang Provincial People’s Hospital, No. 2020QT251.
Informed consent statement: For the characteristics of retrospective study, formal written consent is not applicable.
Conflict-of-interest statement: The author declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at email address. Participants informed consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yang Wen, MD, Chief Doctor, Department of Radiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310000, Zhejiang Province, China. 13989454104@163.com
Received: April 25, 2021
Peer-review started: April 25, 2021
First decision: June 3, 2021
Revised: June 5, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: October 14, 2021
ARTICLE HIGHLIGHTS
Research background

Synchronous liver metastasis (SLM) frequently occurs in colorectal cancer (CRC). Nearly 50% of CRC patients develop hepatic metastasis, with 15%-25% of them presenting with SLM. The evaluation of SLM in CRC is crucial for a precise and personalized treatment.

Research motivation

To construct prediction models based on magnetic resonance imaging (MRI)-radiomics and clinical parameters to evaluate the chemotherapy response in SLM patients in the context of CRC.

Research objectives

A total of 102 patients with 223 SLM lesions were identified and divided into disease response (DR) and disease non-response (non-DR) to chemotherapy.

Research methods

The MRI-radiomics logistic models containing T2WI, DWI, and portal phase of dynamic contrast-enhanced sequences radiomics models (Ra-T2WI, Ra-DWI and Ra-portal phase of dynamic contrast-enhanced sequences) were constructed after methods of feature dimension, and the respective radiomics score was calculated. Then radiomics-clinical nomogram was generated by combining radiomics score, CA19-9, and clinical N staging.

Research results

The AUCs of the training and validation set of Ra-DWI were 0.652 and 0.661, which were higher than those of Ra-T2WI and Ra-portal phase of dynamic contrast-enhanced sequences. After chemotherapy, the top four delta-radiomics features of Ra-DWI in DR group belonged to gray-level run-length matrices parameters. The radiomics-clinical nomogram was built with an AUC of 0.809 and can effectively discriminate the patients with DR from non-DR.

Research conclusions

MRI-radiomics is conducive to predict chemotherapeutic response in SLM patients. The Ra-DWI logistic model behaved the best in differentiating DR and non-DR. Run-length matrices parameters of Ra-DWI were more sensitive to reflect the delta-radiomics after chemotherapy. The radiomics-clinical nomogram is more effective in predicting chemotherapeutic response.

Research perspectives

This study provides new insights into the potential ability of MRI-radiomics in evaluating chemotherapeutic response in SLM patents. The MRI-radiomics features combined with clinical characteristics is more effective in evaluation.