Abstract

In this work, by using descriptive techniques, the characteristics of the texture of the CT (computed tomography) image of patients with colorectal cancer were extracted and, subsequently, classified in KRAS+ or KRAS-. This was accomplished by using different classifiers, such as Support Vector Machine (SVM), Grading Boosting Machine (GBM), Neural Networks (NNET), and Random Forest (RF). Texture analysis can provide a quantitative assessment of tumour heterogeneity by analysing both the distribution and relationship between the pixels in the image. The objective of this research is to demonstrate that CT-based Radiomics can predict the presence of mutation in the KRAS gene in colorectal cancer. This is a retrospective study, with 47 patients from the University Hospital, with a confirmatory pathological analysis of KRAS mutation. The highest accuracy and kappa achieved were 83% and 64.7%, respectively, with a sensitivity of 88.9% and a specificity of 75.0%, achieved by the NNET classifier using the texture feature vectors combining wavelet transform and Haralick coefficients. The fact of being able to identify the genetic expression of a tumour without having to perform either a biopsy or a genetic test is a great advantage, because it prevents invasive procedures that involve complications and may present biases in the sample. As well, it leads towards a more personalized and effective treatment.

Highlights

  • Colorectal cancer is second in incidence in women after breast cancer, followed in third and fourth place by lung and cervix cancers, respectively

  • This set of texture vectors achieved the best performance for classifiers Support Vector Machine (SVM) (59.9%) and Linear Discriminant Analysis (LDA)

  • Our study demonstrated that CT based radiomics can predict the presence of the KRAS mutation in patients with colorectal cancer

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Summary

Introduction

Colorectal cancer is second in incidence in women after breast cancer, followed in third and fourth place by lung and cervix cancers, respectively. The RAS gene is part of the criteria of the new TNM classification of malignant tumours as a prognostic and predictive factor, since patients with early stage colorectal cancer (I and II) have a lower survival rate when related to the KRAS mutation. In addition to combined chemotherapy regimens, there are currently a series of agents that act against certain specific targets important in the pathological process of CRC (colorectal cancer). These therapies are monoclonal antibodies against EGFR, monoclonal antibodies against VEGF-A, and fusion proteins against multiple molecules and growth factors

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