Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2021

01-06-2021 | Computed Tomography | Hepatobiliary Tumors

Radiomics Texture Analysis for the Identification of Colorectal Liver Metastases Sensitive to First-Line Oxaliplatin-Based Chemotherapy

Authors: Ryota Nakanishi, MD, PhD, Eiji Oki, MD, PhD, Hirofumi Hasuda, MD, Eiki Sano, MD, Yu Miyashita, MD, Akihiro Sakai, MD, Naomichi Koga, MD, Naotaka Kuriyama, MD, Kentaro Nonaka, MD, Yoshiaki Fujimoto, MD, Tomoko Jogo, MD, Kentaro Hokonohara, MD, PhD, Qingjiang Hu, MD, PhD, Yuichi Hisamatsu, MD, PhD, Koji Ando, MD, PhD, Yasue Kimura, MD, PhD, Tomoharu Yoshizumi, MD, PhD, Masaki Mori, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2021

Login to get access

Abstract

Objective

The aim of this study was to develop a radiomics-based prediction model for the response of colorectal liver metastases to oxaliplatin-based chemotherapy.

Methods

Forty-two consecutive patients treated with oxaliplatin-based first-line chemotherapy for colorectal liver metastasis at our institution from August 2013 to October 2019 were enrolled in this retrospective study. Overall, 126 liver metastases were chronologically divided into the training (n = 94) and validation (n = 32) cohorts. Regions of interest were manually segmented, and the best response to chemotherapy was decided based on Response Evaluation Criteria in Solid Tumors (RECIST). Patients who achieved clinical complete and partial response according to RECIST were defined as good responders. Radiomics features were extracted from the pretreatment enhanced computed tomography scans, and a radiomics score was calculated using the least absolute shrinkage and selection operator regression model in a trial cohort.

Results

The radiomics score significantly discriminated good responders in both the trial (area under the curve [AUC] 0.8512, 95% confidence interval [CI] 0.7719–0.9305; p < 0.0001) and validation (AUC 0.7792, 95% CI 0.6176–0.9407; p < 0.0001) cohorts. Multivariate analysis revealed that high radiomics scores greater than − 0.06 (odds ratio [OR] 23.803, 95% CI 8.432–80.432; p < 0.0001), clinical non-T4 (OR 6.054, 95% CI 2.164–18.394; p = 0.0005), and metachronous disease (OR 11.787, 95% CI 2.333–70.833; p = 0.0025) were independently associated with good response.

Conclusions

Radiomics signatures may be a potential biomarker for the early prediction of chemosensitivity in colorectal liver metastases. This approach may support the treatment strategy for colorectal liver metastasis.
Appendix
Available only for authorised users
Literature
1.
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Abate D, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the Global Burden of Disease Study. JAMA Oncol. 2019;5(12):1749–68.CrossRef
2.
Adam R, Delvart V, Pascal G, et al. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg. 2004;240(4):644–57 (discussion 657–648).CrossRef
3.
Folprecht G, Grothey A, Alberts S, Raab HR, Kohne CH. Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol. 2005;16(8):1311–9.CrossRef
4.
Van Cutsem E, Cervantes A, Nordlinger B, Arnold D, Group EGW. Metastatic colorectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):iii1-9.PubMed
5.
Benson AB 3rd, Venook AP, Cederquist L, et al. Colon cancer, version 1.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15(3):370–98.
6.
Oki E, Kato T, Bando H, et al. A multicenter clinical phase II study of FOLFOXIRI plus bevacizumab as first-line therapy in patients with metastatic colorectal cancer: QUATTRO study. Clin Colorectal Cancer. 2018;17(2):147–55.CrossRef
7.
Oki E, Emi Y, Yamanaka T, et al. Randomised phase II trial of mFOLFOX6 plus bevacizumab versus mFOLFOX6 plus cetuximab as first-line treatment for colorectal liver metastasis (ATOM trial). Br J Cancer. 2019;121(3):222–9.CrossRef
8.
Masi G, Loupakis F, Pollina L, et al. Long-term outcome of initially unresectable metastatic colorectal cancer patients treated with 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) followed by radical surgery of metastases. Ann Surg. 2009;249(3):420–5.CrossRef
9.
Stelzner S, Radulova-Mauersberger O, Zschuppe E, et al. Prognosis in patients with synchronous colorectal cancer metastases after complete resection of the primary tumor and the metastases. J Surg Oncol. 2019;120(3):438–45.
10.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47.CrossRef
11.
Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48(4):441–6.CrossRef
12.
Aerts HJ, Velazquez ER, Leijenaar RT, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.CrossRef
13.
Ahn SJ, Kim JH, Park SJ, Han JK. Prediction of the therapeutic response after FOLFOX and FOLFIRI treatment for patients with liver metastasis from colorectal cancer using computerized CT texture analysis. Eur J Radiol. 2016;85(10):1867–74.CrossRef
14.
Klaassen R, Larue R, Mearadji B, et al. Feasibility of CT radiomics to predict treatment response of individual liver metastases in esophagogastric cancer patients. PLoS One. 2018;13(11):e0207362.CrossRef
15.
Dercle L, Lu L, Schwartz LH, et al. Radiomics response signature for identification of metastatic colorectal cancer sensitive to therapies targeting EGFR pathway. J Natl Cancer Inst. 2020;112(9):902–12.CrossRef
16.
Cheng J, Wei J, Tong T, et al. Prediction of histopathologic growth patterns of colorectal liver metastases with a noninvasive imaging method. Ann Surg Oncol. 2019;26(13):4587–98.
17.
Liao H, Zhang Z, Chen J, et al. Preoperative radiomic approach to evaluate tumor-infiltrating CD8(+) T cells in hepatocellular carcinoma patients using contrast-enhanced computed tomography. Ann Surg Oncol. 2019;26(13):4537–47.
18.
Nakanishi R, Akiyoshi T, Toda S, et al. Radiomics approach outperforms diameter criteria for predicting pathological lateral lymph node metastasis after neoadjuvant (chemo)radiotherapy in advanced low rectal cancer. Ann Surg Oncol. 2020;27(11):4273–83.
19.
Zhang H, Li W, Hu F, Sun Y, Hu T, Tong T. MR texture analysis: potential imaging biomarker for predicting the chemotherapeutic response of patients with colorectal liver metastases. Abdom Radiol (NY). 2019;44(1):65–71.
20.
Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol. 2004;22(2):229–37.CrossRef
21.
Song J, Yin Y, Wang H, Chang Z, Liu Z, Cui L. A review of original articles published in the emerging field of radiomics. Eur J Radiol. 2020;127:108991.CrossRef
22.
Venook AP, Niedzwiecki D, Lenz HJ, et al. Effect of first-line chemotherapy combined with cetuximab or bevacizumab on overall survival in patients with KRAS wild-type advanced or metastatic colorectal cancer: a randomized clinical trial. JAMA. 2017;317(23):2392–401.CrossRef
23.
Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N Engl J Med. 2003;349(3):247–57.CrossRef
24.
Ding L, Chen F. Predicting tumor response to PD-1 blockade. N Engl J Med. 2019;381(5):477–9.CrossRef
25.
Ganesh K, Stadler ZK, Cercek A, et al. Immunotherapy in colorectal cancer: rationale, challenges and potential. Nat Rev Gastroenterol Hepatol. 2019;16(6):361–75.CrossRef
26.
Baek HJ, Kim HS, Kim N, Choi YJ, Kim YJ. Percent change of perfusion skewness and kurtosis: a potential imaging biomarker for early treatment response in patients with newly diagnosed glioblastomas. Radiology. 2012;264(3):834–43.CrossRef
27.
Aker M, Ganeshan B, Afaq A, Wan S, Groves AM, Arulampalam T. Magnetic resonance texture analysis in identifying complete pathological response to neoadjuvant treatment in locally advanced rectal cancer. Dis Colon Rectum. 2019;62(2):163–70.CrossRef
28.
Papanikolaou N, Matos C, Koh DM. How to develop a meaningful radiomic signature for clinical use in oncologic patients. Cancer Imaging. 2020;20(1):33.CrossRef
29.
Dercle L, Ma J, Xie C, et al. Using a single abdominal computed tomography image to differentiate five contrast-enhancement phases: a machine-learning algorithm for radiomics-based precision medicine. Eur J Radiol. 2020;125:108850.CrossRef
30.
Wu JB, Sarmiento AL, Fiset PO, et al. Histologic features and genomic alterations of primary colorectal adenocarcinoma predict growth patterns of liver metastasis. World J Gastroenterol. 2019;25(26):3408–25.CrossRef
31.
Sammour T, Bedrikovetski S. Radiomics for diagnosing lateral pelvic lymph nodes in rectal cancer: artificial intelligence enabling precision medicine? Ann Surg Oncol. 2020;27(11):4082–3.
32.
Cho YS, Cho K, Park CJ, et al. Automated measurement of hydrops ratio from MRI in patients with Meniere’s disease using CNN-based segmentation. Sci Rep. 2020;10(1):7003.CrossRef
33.
Chun YS, Vauthey JN, Boonsirikamchai P, et al. Association of computed tomography morphologic criteria with pathologic response and survival in patients treated with bevacizumab for colorectal liver metastases. JAMA. 2009;302(21):2338–44.CrossRef
34.
Nishioka Y, Shindoh J, Yoshioka R, et al. Clinical impact of preoperative chemotherapy on microscopic cancer spread surrounding colorectal liver metastases. Ann Surg Oncol. 2017;24(8):2326–33.
35.
Dworak O, Keilholz L, Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy. Int J Colorectal Dis. 1997;12(1):19–23.CrossRef
Metadata
Title
Radiomics Texture Analysis for the Identification of Colorectal Liver Metastases Sensitive to First-Line Oxaliplatin-Based Chemotherapy
Authors
Ryota Nakanishi, MD, PhD
Eiji Oki, MD, PhD
Hirofumi Hasuda, MD
Eiki Sano, MD
Yu Miyashita, MD
Akihiro Sakai, MD
Naomichi Koga, MD
Naotaka Kuriyama, MD
Kentaro Nonaka, MD
Yoshiaki Fujimoto, MD
Tomoko Jogo, MD
Kentaro Hokonohara, MD, PhD
Qingjiang Hu, MD, PhD
Yuichi Hisamatsu, MD, PhD
Koji Ando, MD, PhD
Yasue Kimura, MD, PhD
Tomoharu Yoshizumi, MD, PhD
Masaki Mori, MD, PhD
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09581-5

Other articles of this Issue 6/2021

Annals of Surgical Oncology 6/2021 Go to the issue

Translational Research

Clinicopathological Features and Outcomes in Individuals with Breast Cancer and ATM, CHEK2, or PALB2 Mutations

ASO Author Reflections

ASO Author Reflections: Recurrence After Pathological Complete Response in Esophageal Cancer: Analysis of Risk Factors for this Unexpected Event

Gastrointestinal Oncology

The Undertreatment of Gallbladder Cancer: Gaps in Seeking, Reaching, and Receiving Care

Gynecologic Oncology

The Role of Secondary Cytoreductive Surgery in Recurrent Ovarian Cancer: A Systematic Review and Meta-Analysis

ASO Author Reflections

ASO Author Reflections: The Pursuit of Eliminating Surgery after Neoadjuvant Systemic Therapy in Breast Cancer Patients

Gynecologic Oncology

Is a Vaginectomy Enough or is a Pelvic Exenteration Always Required for Surgical Treatment of Recurrent Cervical Cancer? A Propensity-Matched Study