Multiparameter MRI-based radiomics for preoperative prediction of extramural venous invasion in rectal cancer

To compare multiparameter MRI-based radiomics for preoperative prediction of extramural venous invasion (EMVI) in rectal cancer using different machine learning algorithms and to develop and validate the best diagnostic model.

We retrospectively analyzed 317 patients with rectal cancer. Of these, 114 were EMVI positive and 203 were EMVI negative. Radiomics features were extracted from T₂-weighted imaging, T₁-weighted imaging, diffusion-weighted imaging, and enhanced T₁-weighted imaging of rectal cancer, followed by the dimension reduction of the features. Logistic regression, support vector machine, Bayes, K-nearest neighbor, and random forests algorithms were trained to obtain the radiomics signatures. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of each radiomics signature. The best radiomics signature was selected and combined with clinical and radiological characteristics to construct a joint model for predicting EMVI. Finally, the predictive performance of the joint model was assessed.

The Bayes-based radiomics signature performed well in both the training set and the test set, with the AUCs of 0.744 and 0.738, sensitivities of 0.754 and 0.728, and specificities of 0.887 and 0.918, respectively. The joint model performed best in both the training set and the test set, with the AUCs of 0.839 and 0.835, sensitivities of 0.633 and 0.714, and specificities of 0.901 and 0.885, respectively.

The joint model demonstrated the best diagnostic performance for the preoperative prediction of EMVI in patients with rectal cancer. Hence, it can be used as a key tool for clinical individualized EMVI prediction.

• Radiomics features from magnetic resonance imaging can be used to predict extramural venous invasion (EMVI) in rectal cancer. • Machine learning can improve the accuracy of predicting EMVI in rectal cancer. • Radiomics can serve as a noninvasive biomarker to monitor the status of EMVI.