Abstract
Diffusion weighted imaging (DWI) at multiple b-values has been used to predict the pathological complete response (pCR) to neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Non-Gaussian models fit the signal decay of diffusion by several physical values from different approaches of approximation. To develop a deep learning method to analyze DWI data scanned at multiple b-values independent on Gaussian or non-Gaussian models and to apply to a rectal cancer neoadjuvant chemoradiotherapy model. Retrospective. A total of 472 participants (age: 56.6 ± 10.5 years; 298 males and 174 females) with locally advanced adenocarcinoma were enrolled and chronologically divided into a training group (n=200; 42 pCR/158 non-pCR), a validation group (n= 72; 11 pCR/61 non-pCR) and a test group (n=200; 44 pCR/156 non-pCR). A 3.0 T MRI scanner. DWI with a single-shot spin echo-planar imaging pulse sequence at 12 b-values (0, 20, 50, 100, 200, 400, 600, 800, 1000, 1200, 1400, and 1600 sec/mm2 ). DWI signals from manually delineated tumor region were converted into a signature-like picture by concatenating all histograms from different b-values. Pathological results (pCR/non-pCR) were used as the ground truth for deep learning. Gaussian and non-Gaussian methods were used for comparison. Analysis of variance for age; Chi-square for gender and pCR/non-pCR; area under the receiver operating characteristic (ROC) curve (AUC); DeLong test for AUC. P < 0.05 for significant difference. The AUC in the test group is 0.924 (95% CI: 0.866-0.983) for the signature-like pictures converted from 35 bins, and it is 0.931 (95% CI: 0.884-0.979) for the signature-like pictures converted from 70 bins, which is significantly (Z=3.258, P < 0.05) larger than Dapp , the best predictor in non-Gaussian methods with AUC=0.773 (95% CI: 0.682-0.865). The proposed signature-like pictures provide more accurate pretreatment prediction of the response to neoadjuvant chemoradiotherapy than the fitted methods for locally advanced rectal cancer. 3 TECHNICAL EFFICACY: Stage 2.
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