Predictive Value of Multi-Phase CT Radiomics in Delineating Early and Advanced T Staging of Colon Cancer

Abstract

This study leveraged the power of multi-phase CT radiomics, which extracts detailed features from multi-phase images, to explore the distinction between early (T1-T2) and advanced (T3-T4) colon cancer stages in each of multiple phases, providing valuable insights to healthcare professionals and enhancing their decision-making capabilities. A total of 191 patients with surgically confirmed primary colon cancer were retrospectively included, and multi-phase CT scans (non-enhanced contrast phase, arterial phase, portal venous phase, and delayed phase) were conducted within one week before surgery. Three-dimensional segmentation of colonic tumors was performed on the images of the four phases, and radiomics features of each colonic tumor were automatically extracted. Minimum redundancy maximum relevance (mRMR) was applied to features selection in each of the four phases. The least absolute shrinkage and selection operator logistic regression was conducted to determine the association between radiomics features and early (T1-T2) and advanced (T3-T4) stages of colon cancer. Additionally, diagnostic performance comparison was carried out in four phases. The mean (±SD) age of the 191 individuals was 61.87±13.137 years, with females comprising 43.5% of the cohort. The selected features for the non-enhanced, arterial, portal venous, and delayed phases numbered 7, 11, 6, and 10, respectively. In the test set, the AUC values for the on-enhanced, arterial, portal venous, and delayed phases were 0.86 (0.76-0.96), 0.84 (0.73-0.94), 0.82 (0.71-0.93), and 0.86 (0.75-0.97), with corresponding accuracies of 0.84, 0.80, 0.75, and 0.88, sensitivities of 0.73, 0.64, 0.86, and 0.68, and specificities of 0.91, 0.91, 0.68, and 1.00, respectively. DeLong's test revealed no statistically significant differences in the AUC values between the four phases within the test sets (P = 0.3233~ 0.9912). Multi-phase CT radiomics demonstrated substantial value in differentiating between early (T1-T2) and advanced (T3-T4) stages of patients with colon cancer.