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Magnetic resonance-based texture parameters as potential imaging biomarkers for predicting long term survival in locally advanced rectal cancer treated by chemoradiotherapy

Jalil, O; Afaq, A; Ganeshan, B; Patel, UB; Boone, D; Endozo, R; Groves, A; ... Arulampalam, T; + view all (2017) Magnetic resonance-based texture parameters as potential imaging biomarkers for predicting long term survival in locally advanced rectal cancer treated by chemoradiotherapy. Colorectal Disease , 19 (4) pp. 349-362. 10.1111/codi.13496. Green open access

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Abstract

AIM: The study aimed to investigate whether textural features of rectal cancer on magnetic resonance imaging (MRI) can predict long term survival in patients treated with long-course chemoradiotherapy. METHOD: Textural analysis (TA) using a filtration-histogram technique of T2-weighted pre- and six-week post chemoradiotherapy MRI was undertaken using TexRAD, a proprietary software algorithm. Regions of interest enclosing the largest cross-sectional area of the tumour were manually delineated on the axial images and filtration-step extracted features at different anatomical scales (fine, medium, and coarse) followed by quantification of statistical features (mean intensity, standard-deviation, entropy, skewness, kurtosis and mean of positive pixels [MPP]) using histogram analysis. Cox multiple regression analysis determined which univariate features including textural, radiological and histological, independently predicted overall survival (OS), disease free survival (DFS) and recurrence-free survival (RFS). RESULTS: MPP (fine-texture, HR: 6.9, 95% CI [2.43-19.55], p= <0.001), mean (medium-texture, HR: 5.6 [1.4-21.7], p=0.007) and extramural venous invasion (EMVI) on MRI (HR: 2.96, [1.04-8.37], p=0.041) independently predicted OS while mean (medium texture, HR: 4.53, [1.58-12.94], p=0.003), MPP (fine texture, HR: 3.36 [1.36-8.31], p=0.008) and threatened circumferential resection margin (CRM) on MRI (HR: 3.1 [1.01-9.46], p=0.046) predicted DFS. For OS; EMVI on MRI (HR: 4.23 [1.41-12.69], p=0.01) and for DFS; kurtosis (medium-texture, HR: 3.97 [1.44-10.94], p=0.007) and CRM involvement on MRI (HR: 3.36 [1.21-9.32], p=0.02) were the independent post-treatment factors. Only TA independently predicted RFS on pre- or post-treatment analyses. CONCLUSION: MR based TA of rectal cancers can predict outcome before undergoing surgery and could potentially select patients for individualized therapy. This article is protected by copyright. All rights reserved.

Type: Article
Title: Magnetic resonance-based texture parameters as potential imaging biomarkers for predicting long term survival in locally advanced rectal cancer treated by chemoradiotherapy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/codi.13496
Publisher version: https://doi.org/10.1111/codi.13496
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: MRI, Textural analysis, imaging biomarker, neoadjuvant chemoradiotherapy, rectal cancer
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
URI: https://discovery.ucl.ac.uk/id/eprint/1516554
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