Abstract
Background and PurposeLocally advanced rectal cancer (LARC) is a heterogeneous disease with little information about KRAS status and image features. The purpose of this study was to analyze the association between T2 magnetic resonance imaging (MRI) radiomics features and KRAS status in LARC patients.Material and MethodsEighty-three patients with KRAS status information and T2 MRI images between 2012.05 and 2019.09 were included. Least absolute shrinkage and selection operator (LASSO) regression was performed to assess the associations between features and gene status. The patients were divided 7:3 into training and validation sets. The C-index and the average area under the receiver operator characteristic curve (AUC) were used for performance evaluation.ResultsThe clinical characteristics of 83 patients in the KRAS mutant and wild-type cohorts were balanced. Forty-two (50.6%) patients had KRAS mutations, and 41 (49.4%) patients had wild-type KRAS. A total of 253 radiomics features were extracted from the T2-MRI images of LARC patients. One radiomic feature named X.LL_scaled_std, a standard deviation value of scaled wavelet-transformed low-pass channel filter, was selected from 253 features (P=0.019). The radiomics-based C-index values were 0.801 (95% CI: 0.772-0.830) and 0.703 (95% CI: 0.620-0.786) in the training and validation sets, respectively.ConclusionRadiomics features could differentiate KRAS status in LARC patients based on T2-MRI images. Further validation in a larger dataset is necessary in the future.
Highlights
Colorectal cancer (CRC) is one of the most prevalent cancers worldwide, and locally advanced rectal cancer (LARC) shows strong heterogeneity in real-world medical practice
For the validation of the CTbased model, the accuracy of the validation cohort was 0.750 (95% CI, 0.623-0.845), with a sensitivity of 0.686 and a specificity of 0.857
The value of radiomics was highly related to genetic mutations, with P
Summary
Colorectal cancer (CRC) is one of the most prevalent cancers worldwide, and locally advanced rectal cancer (LARC) shows strong heterogeneity in real-world medical practice. With follow-up data maturing and treatments evolving, more studies are challenging this opinion based on the findings that KRAS-mut patients have worse OS and DFS [4, 5]. Most of these studies were conducted in CRC patients, and the number of patients with KRAS mutations was limited because their main research objective was immune-related biomarkers. Information on KRAS mutation status has great meaning for physicians in predicting patient response to neoadjuvant chemotherapy and prognosis in practical medical treatment. Advanced rectal cancer (LARC) is a heterogeneous disease with little information about KRAS status and image features. The purpose of this study was to analyze the association between T2 magnetic resonance imaging (MRI) radiomics features and KRAS status in LARC patients
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