CT-based radiomics for the identification of colorectal cancer liver metastases sensitive to first-line irinotecan-based chemotherapy.

Abstract

Chemosensitivity prediction in colorectal cancer patients with liver metastases has remained a research hotspot. Radiomics can extract features from patient imaging, and deep learning or machine learning can be used to build models to predict patient outcomes prior to chemotherapy. In this study, the radiomics features and clinical data of colorectal cancer patients with liver metastases were used to predict their sensitivity to irinotecan-based chemotherapy. A total of 116 patients with unresectable colorectal cancer liver metastases who received first-line irinotecan-based chemotherapy from January 2015 to January 2020 in our institution were retrospectively collected. Overall, 116 liver metastases were randomly divided into training (n = 81) and validation (n = 35) cohorts in a 7:3 ratio. The effect of chemotherapy was determined based on Response Evaluation Criteria in Solid Tumors. The lesions were divided into response and nonresponse groups. Regions of interest (ROIs) were manually segmented, and sample sizes of 1×1×1, 3×3×3, 5×5×5 mm3 were used to extract radiomics features. The relevant features were identified through Pearson correlation analysis and the MRMR algorithm, and the clinical data were merged into the artificial neural network. Finally, the p-model was obtained after repeated learning and testing. The p-model could distinguish responders in the training (area under the curve [AUC] 0.754, 95% CI 0.650-0.858) and validation cohorts (AUC 0.752 95% CI 0.581-0.904). AUC values of the pure image group model are 0.720 (95% CI 0.609-0.827) and 0.684 (95% CI 0.529-0.890) for the training and validation cohorts respectively. As for the clinical data model, AUC values of the training and validation cohorts are 0.638 (95% CI 0.500-0.757) and 0.545 (95% CI 0.360-0.785), respectively. The performances of the latter two are less than that of the former. The p-model has the potential to discriminate colorectal cancer patients sensitive to chemotherapy. This model holds promise as a noninvasive tool to predict the response of colorectal liver metastases to chemotherapy, allowing for personalized treatment planning.