Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6465
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
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.
To construct prediction models based on magnetic resonance imaging (MRI)-ra
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.
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.
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.
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.
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.