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Updated: May 14, 2026

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Radiomics' Role in Predicting Distant Metastases, Recurrence and Survival Outcome in Rectal Cancer: A Systematic

Huda Mohammed¹, Hadeel Mohamed², Momoh Fofana³

¹General Surgery Department, Craigavon Area Hospital, Craigavon BT63 5QQ, UK.

|May 13, 2026

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Radiomics, extracting data from medical images, shows promise for predicting rectal cancer outcomes like metastasis and recurrence. More prospective studies are needed to integrate this non-invasive tool into clinical practice.

Area of Science:

Oncology
Medical Imaging
Radiology

Background:

Radiomics offers quantitative insights for rectal cancer (RC) management.
Accurate prediction of lymph node status, metastasis, recurrence, and survival is crucial in RC.

Purpose of the Study:

To systematically review the literature on radiomics' role in predicting outcomes for rectal cancer.
To assess the current evidence regarding radiomics in lymph node and distant metastasis prediction, local recurrence, and survival.

Main Methods:

Systematic literature review following PRISMA guidelines.
Searched PubMed, Cochrane, Google Scholar, and ResearchGate for relevant articles.
Included 50 studies after quality assessment (mean Radiomics Quality Score: 14.74).

Keywords:

computed tomography CT disease free survival distant metastasis local recurrence lymph node metastasis magnetic resonance imaging MRI overall survival radiomics rectal cancer rectal carcinoma

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Main Results:

Most studies (predominantly MRI-based) concluded that radiomic models outperform clinical analysis for outcome prediction.
Eight studies utilized CT radiomics; only three were prospective.
Fourteen studies included external validation, indicating growing model robustness.

Conclusions:

Radiomics shows significant potential as a non-invasive tool for predicting rectal cancer lymph node status, distant metastasis, recurrence, and survival.
Further high-quality prospective studies with cost-benefit analyses are essential for clinical implementation.
Standardization and validation are key for integrating radiomics into routine rectal cancer care.