ThTP4.4 Textural Analysis as a Predictive Biomarker in Rectal Cancer

Abstract

Abstract Background Colorectal cancer (CRC) is common and accurate staging enhances a better prognosis. Pelvic MRI is the gold standard for Rectal cancer staging. Textural analysis (TA) is a radiomic process that quantifies lesions’ heterogenicity by measuring pixel distribution in digital imaging. MRI TA of rectal cancer images is considered a future predictor of its outcomes. This review summarizes the potential role of TA in rectal cancer’s prognosis. Methods Searches were done using Medline, Embase, and PubMed. Only English articles and human studies were included. Key findings and future research suggestions were highlighted to delineate the gap in TA use. Review analysis Some studies established a correlation between TA and rectal cancer outcomes, such as treatment response, survival, and distant spread. Research showed that TA of MRI could differentiate complete from partial responders to Neo-adjuvant radio-chemotherapy. The response was higher in the mid-treatment MRI but lower in the pre-treatment. The pre-and post-treatment MRIs were significant markers of overall survival, disease-free survival, and relapse-free survival in Locally Advanced Rectal Cancer patients.MR morphological features showed the ability to define either local or distant recurrence. TA showed an ability to predict liver metastasis in CRC; Entropy and uniformity were significant predictors of patients’ liver metastases compared to patients with normal liver. Conclusion Medical images TA could predict important clinical outcomes in rectal cancer; eventually, this could change rectal cancer management into more personalized treatment options (watchful waiting). More prospective and randomized trials are mandatory to overcome TA standardization challenges.