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Multiparametric MRI-based radiomics signature for preoperative estimation of tumor-stroma ratio in rectal cancer

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine whether a radiomics signature (rad-score) outperforms ADC in TSR estimation by developing a radiomics biomarker for preoperative TSR diagnosis in rectal cancer.

Methods

This study included 149 patients (119 and 30 in the training and validation cohorts, respectively). All patients underwent T2-weighted, diffusion-weighted, and contrast-enhanced T1-weighted imaging. A rad-score was generated using the least absolute shrinkage and selection operator (LASSO) algorithm and stepwise multivariate logistic regression. Meanwhile, the mean ADCs were calculated from ADC maps. For both the mean ADC and rad-score, binary logistic regression and Spearman correlation coefficients were used to determine associations with the TSR, and the area under the receiver operating characteristic (ROC) curve was used to assess the diagnostic performance. The reliability of the rad-score was quantified by comparing the imaging-estimated TSR with the actual TSR of each patient.

Results

Both the mean ADC and rad-score were positively correlated with the TSR in the training cohort (mean ADC: p < 0.001, r = 0.566; rad-score: p < 0.001, r = 0.559) and validation cohort (mean ADC: p < 0.001, r = 0.671; rad-score: p = 0.002, r = 0.536). The rad-score, with AUCs of 0.917 (95% CI 0.869–0.965) and 0.787 (95% CI 0.602–0.972) in the training and validation cohorts, respectively, outperformed the mean ADC (training cohort: AUC = 0.776, 95% CI 0.693–0.859; validation cohort: AUC = 0.764, 95% CI 0.592–0.936) in TSR estimation.

Conclusion

The ADC possesses potential diagnostic value for TSR estimation in rectal cancer, and the rad-score shows increased diagnostic value over the ADC and may be a promising supplemental tool for patient stratification and informing decision-making.

Key Points

• Tumor-stroma ratio has been verified as an independent prognostic factor for various solid tumors including rectal cancer.

• The ADC and multiparametric MRI-based radiomics features were significantly and positively correlated with the tumor-stroma ratio in rectal cancer.

• The radiomics signature outperformed the ADC in discriminating TSR in rectal cancer.

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Abbreviations

ADC:

Apparent diffusion coefficient

CRC:

Colorectal cancer

DWIs:

Diffusion-weighted images

LASSO:

Least absolute shrinkage and selection operator

ROC:

Receiver operating characteristic

TSE:

Turbo spin-echo

TSR:

Tumor-stroma ratio

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Acknowledgments

This study has received funding from the National Natural Science Foundation of China (grant number: 81971687) and Shanghai Sailing program (grant number: 19YF1409900).

Funding

This study has received funding from the National Natural Science Foundation of China (grant number: 81971687) and Shanghai Sailing program (grant number: 19YF1409900).

Author information

Author notes

  1. Chongpeng Cai and Tingdan Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China

    Chongpeng Cai, Tingdan Hu, Jing Gong & Tong Tong

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

    Chongpeng Cai, Tingdan Hu, Jing Gong & Tong Tong

  3. Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China

    Dan Huang

  4. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

    Fangqi Liu

  5. MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China

    Caixia Fu

Authors
  1. Chongpeng Cai
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  2. Tingdan Hu
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  3. Jing Gong
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  4. Dan Huang
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  5. Fangqi Liu
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  6. Caixia Fu
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  7. Tong Tong
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Corresponding author

Correspondence to Tong Tong.

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Guarantor

The scientific guarantor of this publication is Tong Tong.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

This study is retrospective study and does not require informed consent.

Ethical approval

Institutional Review Board approval was obtained.

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Cai, C., Hu, T., Gong, J. et al. Multiparametric MRI-based radiomics signature for preoperative estimation of tumor-stroma ratio in rectal cancer. Eur Radiol 31, 3326–3335 (2021). https://doi.org/10.1007/s00330-020-07403-6

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  • DOI: https://doi.org/10.1007/s00330-020-07403-6

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