Objective:The radiomics features of locally advanced rectal cancer(LARC)lesions were extracted using the MRI radiomics method,and a prediction model was constructed by combining clinical and conventional imaging features to explore the predictive efficacy of the model on the efficacy of neoadjuvant chemoradiotherapy(nCRT).Methods:The clinical and imaging data of 209 LARC pa-tients before nCRT were retrospectively analyzed.Total mesorectal resection(TME)was performed on the patients with LARC 6～8 weeks after nCRT,and were assessed for tumor pathological regres-sion grading(TRG).According to the efficacy,the patients were divided into a group of good nCRT response(TRG0～1 grade)and a group of poor response(TRG2～3 grade).It were randomly divided into training and verification group in accordance with 1:1 for internal verification of the model.The radiomics features were extracted through mannually sketching the transverse,sagittal and coronal T2WI images.The features were screened by LASSO regression,and the radiomics labels were con-structed.Then,the independent predictors of the efficacy of nCRT were screened by multifactorial lo-gistic analysis to construct prediction model.The ROC curves and correction curves were used to eval-uate the model,and the clinical value of the model was evaluated by clinical decision curves.Results:A-mong 209 patients,61 had good nCRT response and 148 had poor nCRT response.A total of 379 ra-diomics features were extracted from each of the transverse,sagittal and coronal T2WI images.The features with ICC≥0.9:TRA:96,SAG:88,COR:91.LASSO regression screening features:TRA:4,SAG:5,COR:2,COM:7.The AUC values of TRA,SAG,COR and COM radiomics labels models in predicting the efficacy of nCRT were 0.637,0.682,0.619 and 0.731,respectively.The results of multi-variate logistic analysis showed that the COM radiomics labelling,elevated CEA level(＞3.4ng/mL)and extra-mural vascular invasion(EMVI)were independent predictors of the efficacy of nCRT.The area of AUC cureve of prediction model was 0.811.The model was well validated internally,with high calibration,and the clinical decision curve showed high clinical application value.Conclusions:The multi-directional radiomics labels constructed by combining transverse,sagittal and coronal images form T2WI sequences can predict the efficacy of nCRT in LARC patients.The predictive efficacy of the model is further improved by combining the elevated CEA(＞3.4ng/mL),EMVI and COM radiomics label,which can assist in formulating individualized diagnosis and treatment plans to achieve maximum benefits.
维普
万方数据