Zhang YC, Li M, Jin YM, Xu JX, Huang CC, Song B. Radiomics for differentiating tumor deposits from lymph node metastasis in rectal cancer. World J Gastroenterol 2022; 28(29): 3960-3970 [PMID: 36157536 DOI: 10.3748/wjg.v28.i29.3960]
Corresponding Author of This Article
Bin Song, MD, PhD, Chief Doctor, Professor, Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. songlab_radiology@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 7, 2022; 28(29): 3960-3970 Published online Aug 7, 2022. doi: 10.3748/wjg.v28.i29.3960
Radiomics for differentiating tumor deposits from lymph node metastasis in rectal cancer
Yong-Chang Zhang, Mou Li, Yu-Mei Jin, Jing-Xu Xu, Chen-Cui Huang, Bin Song
Yong-Chang Zhang, Department of Radiology, Chengdu Seventh People’s Hospital, Chengdu 610213, Sichuan Province, China
Yong-Chang Zhang, Mou Li, Yu-Mei Jin, Bin Song, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jing-Xu Xu, Chen-Cui Huang, Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co., Ltd, Beijing 100080, China
Author contributions: Song B designed the research; Zhang YC and Jin YM collected the data; Li M, Xu JX, and Huang CC analyzed the data; Zhang YC and Li M wrote the paper; all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of West China Hospital of Sichuan University, No. 1159.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Authors Jing-Xu Xu and Chen-Cui Huang are employed by the company Beijing Deepwise & League of PHD Technology Co., Ltd; the remaining authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Song, MD, PhD, Chief Doctor, Professor, Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. songlab_radiology@163.com
Received: December 29, 2021 Peer-review started: December 29, 2021 First decision: March 10, 2022 Revised: March 28, 2022 Accepted: July 6, 2022 Article in press: July 6, 2022 Published online: August 7, 2022 Processing time: 217 Days and 1.6 Hours
ARTICLE HIGHLIGHTS
Research background
Tumor deposits (TDs) are not equivalent to lymph node (LN) metastasis (LNM) but have become independent adverse prognostic factors in patients with rectal cancer (RC). If TDs can be differentiated from LNM before therapy, individualized treatment and patient prognosis may greatly improve.
Research motivation
Currently, preoperative differentiation of TDs and LNM can be challenging.
Research objectives
To establish a radiomics model for preoperatively differentiating between TDs and LNM in patients with RC.
Research methods
The present study retrospectively enrolled 219 patients with RC [TDs+LNM- (n = 89); LNM+TDs- (n = 115); TDs+LNM+ (n = 15)] from a single center between September 2016 and September 2021. Single-positive patients (TDs+LNM- and LNM+TDs-) were classified into training (n = 163) and validation (n = 41) sets. Rad-scores were established based on the main tumor and largest peritumoral nodule. After validating Rad-score, we further evaluated its performance for diagnosing double-positive patients (i.e., TDs+LNM+) by outlining all peritumoral nodules with diameters > 3 mm (short axis).
Research results
Rad-score 1 (radiomics signature of the main tumor) had an area under the curve (AUC) of 0.768 on the training dataset and 0.700 on the validation dataset. Rad-score 2 (radiomics signature of the largest peritumoral nodule) had a higher AUC (training set: 0.940; validation set: 0.918) than Rad-score 1. For the diagnosis of double-positive patients in the mixed group [TDs+LNM+ (n = 15); single-positive (n = 15)], Rad-score 2 demonstrated moderate performance (sensitivity, 73.3%; specificity, 66.6%; and accuracy, 70%).
Research conclusions
The radiomics signature of the largest peritumoral nodule could provide individualized preoperative differentiation of TDs and LNM. Moreover, it was helpful in diagnosing patients who were TDs+LNM+.
Research perspectives
To improve the model, surgeons, radiologists, and pathologists should collaborate through prospective research to achieve node-to-node correspondence between CT images and pathological examinations in the future.
