基于MRI的息地分析用于在直肠癌中接受新辅助化疗或放射治疗后预测病理反应:一项多中心研究
Qiaoling Chen1, Qianwen Zhang1, Zhihui Li2
1Department of Radiology, Changhai Hospital, Shanghai, China.
European radiology
|September 22, 2025
概括
结合临床,放射学和内异质性 (ITH) 特征的新型融合模型准确地预测了直肠癌 (RC) 患者对新辅助化学放射治疗 (nCRT) 的反应. 这有助于个性化治疗策略,以获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 在直肠癌 (RC) 中预测治疗反应对于有效的新辅助化学放射治疗 (nCRT) 是至关重要的.
- 从MRI了解瘤内异质性 (ITH) 和放射性特征可以提供对瘤生物学和反应的见解.
研究的目的:
- 评估基于MRI的息地分析的有效性,结合放射学和ITH,预测RC患者对nCRT的病理反应.
- 开发和验证治疗反应的预测模型.
主要方法:
- 使用了1021名RC患者的大队列,分为培训,内部和外部验证集.
- 深度学习在高分辨率MRI上细分瘤;为放射学特征提取集群确定子区域.
- 开发了四种模型:临床模型,基于ITH的模型,放射学模型和结合所有特征的融合模型.
主要成果:
- 与临床,放射学和ITH模型相比,融合模型显示出优异的预测性能 (AUC范围从0.818到0.867跨队列).
- 在融合模型和ITH模型之间没有发现任何显著差异.
- 根据融合模型分层的患者在良好和差反应组之间,在无病生存期 (DFS) 中表现出显著的差异.
结论:
- 融合模型整合了临床因素,放射学和ITH特征,显示了预测RC中nCRT病理反应的重大潜力.
- 这种方法可以帮助识别可能从nCRT中受益的RC患者,支持个性化治疗策略.
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