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- Title
Computed tomography-derived biomarker for predicting the treatment response to neoadjuvant chemoradiotherapy of rectal cancer.
- Authors
Kurata, Yoshihiro; Hayano, Koichi; Ohira, Gaku; Imanishi, Shunsuke; Tochigi, Toru; Isozaki, Tetsuro; Aoyagi, Tomoyoshi; Matsubara, Hisahiro
- Abstract
Background: Malignant tumor essentially implies structural heterogeneity. Analysis of medical imaging can quantify this structural heterogeneity, which can be a new biomarker. This study aimed to evaluate the usefulness of texture analysis of computed tomography (CT) imaging as a biomarker for predicting the therapeutic response of neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer. Methods: We enrolled 76 patients with rectal cancer who underwent curative surgery after nCRT. Texture analyses (Fractal analysis and Histogram analysis) were applied to contrast-enhanced CT images, and fractal dimension (FD), skewness, and kurtosis of the tumor were calculated. These CT-derived parameters were compared with the therapeutic response and prognosis. Results: Forty-six of 76 patients were diagnosed as clinical responders after nCRT. Kurtosis was significantly higher in the responders group than in the non-responders group (4.17 ± 4.16 vs. 2.62 ± 3.19, p = 0.04). Nine of 76 patients were diagnosed with pathological complete response (pCR) after surgery. FD of the pCR group was significantly lower than that of the non-pCR group (0.90 ± 0.12 vs. 1.01 ± 0.12, p = 0.009). The area under the receiver-operating characteristics curve of tumor FD for predicting pCR was 0.77, and the optimal cut-off value was 0.84 (accuracy; 93.4%). Furthermore, patients with lower FD tumors tended to show better relapse-free survival and disease-specific survival than those with higher FD tumors (5-year, 80.8 vs. 66.6%, 94.4 vs. 80.2%, respectively), although it was not statistically significant (p = 0.14, 0.11). Conclusions: CT-derived texture parameters could be potential biomarkers for predicting the therapeutic response of rectal cancer.
- Subjects
RECTAL cancer; CHEMORADIOTHERAPY; BIOMARKERS; COMPUTED tomography; IMAGE analysis; FRACTAL analysis; PROGNOSIS
- Publication
International Journal of Clinical Oncology, 2021, Vol 26, Issue 12, p2246
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-021-02027-2