Locally advanced rectal cancer: predicting non-responders to neoadjuvant chemoradiotherapy using apparent diffusion...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Locally advanced rectal cancer (LARC) requires effective treatment strategies.
• Predicting response to neoadjuvant chemoradiotherapy (NCRT) is crucial for personalized treatment planning.

Purpose of the Study:

• To investigate if apparent diffusion coefficient (ADC) texture analysis can identify LARC patients who will not respond to NCRT.
• To evaluate the potential of pre-treatment ADC texture features in predicting non-response to NCRT.

Main Methods:

• MRI including diffusion-weighted imaging was performed on 26 LARC patients before NCRT.
• Texture analysis of pre-therapy ADC maps extracted 133 ADC texture parameters and mean ADC values.
• Logistic regression and ROC curve analysis identified predictors of non-response.

Main Results:

• Eighteen of 133 texture parameters showed significant differences between responsive and non-responsive groups (p < 0.05).
• Energy variance and SdGa47 were identified as independent predictors of non-response.
• A logistic model using these predictors achieved an AUC of 0.908.

Conclusions:

• Pre-therapy ADC texture analysis shows promise in identifying LARC patients unlikely to respond to NCRT.
• This non-invasive imaging approach may aid in tailoring treatment strategies for rectal cancer.