Abstract
Objective
To develop a T2-weighted (T2W) image-based radiomics signature for the individual prediction of KRAS mutation status in patients with rectal cancer.
Methods
Three hundred four consecutive patients from center I with pathologically diagnosed rectal adenocarcinoma (training dataset, n = 213; internal validation dataset, n = 91) were enrolled in our retrospective study. The patients from center II (n = 86) were selected as an external validation dataset. A total of 960 imaging features were extracted from high-resolution T2W images for each patient. Five steps, mainly univariate statistical tests, were applied for feature selection. Subsequently, three classification methods, i.e., logistic regression (LR), decision tree (DT), and support vector machine (SVM) algorithm, were applied to develop the radiomics signature for KRAS prediction in the training dataset. The predictive performance was evaluated by receiver operating characteristics curve (ROC) analysis, calibration curve, and decision curve analysis (DCA).
Results
Seven radiomics features were screened as a KRAS-associated radiomics signature of rectal cancer. Our best prediction model was obtained with SVM classifiers with AUC of 0.722 (95%CI, 0.654–0.790) in the training dataset. This was validated in the internal and external validation datasets with good calibration, and the corresponding AUCs were 0.682 (95% CI, 0.569–0.794) and 0.714 (95% CI, 0.602–0.827), respectively. DCA confirmed its clinical usefulness.
Conclusions
The proposed T2WI-based radiomics signature has a moderate performance to predict KRAS status, and may be useful for supplementing genomic analysis to determine KRAS expression in rectal cancer patients.
Key Points
• T2WI-based radiomics showed a moderate diagnostic significance for KRAS status.
• The best prediction model was obtained with SVM classifier.
• The baseline clinical and histopathological characteristics were not associated with KRAS mutation.
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Abbreviations
- 3D:
-
Three-dimensional
- ANOVA:
-
Analysis of variance
- ARMS:
-
Amplification-refractory mutation system
- AUC:
-
Area under the ROC curve
- CA199:
-
Carbohydrate antigen-199
- CEA:
-
Carcinoembryonic antigen
- CRC:
-
Colorectal cancer
- DCA:
-
Decision curve analysis
- DKI:
-
Diffusion kurtosis imaging
- DT:
-
Decision tree
- DWI:
-
Diffusion weighted imaging
- EGFR:
-
Epidermal growth factor receptor
- FFPE:
-
Formalin-fixed, paraffin-embedded
- GLCM:
-
Gray-level co-occurrence matrix
- GLDM:
-
Gray-level dependence matrix
- GLRLM:
-
Gray-level run length matrix
- GLSZM:
-
gray-Level size zone matrix
- IVIM:
-
Intravoxel incoherent motion
- KRAS:
-
Kirsten rat sarcoma
- LoG:
-
Laplacian of Gaussian
- LR:
-
Logistic regression
- LVI:
-
Lymphangiovascular invasion
- MRI:
-
Magnetic resonance imaging
- NCCN:
-
National Comprehensive Cancer Network
- PACS:
-
Picture archiving and communication system
- pCR:
-
Pathological complete response
- PCR:
-
Polymerase chain reaction
- RBF:
-
Radial basis function
- ROC:
-
Receiver operating characteristic
- ROI:
-
Regions of interests
- SVM:
-
Support vector machine
- T2W:
-
T2-weighted
- VOI:
-
Volume of interest
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Funding
This study was supported by the National Key Research and Development Program of China (No. 2017YFC0109003), the Special Research Program of Shanghai Municipal Commission of Heath and Family Planning on medical intelligence (No. 2018ZHYL0108), Shanghai Sailing Program (19YF1433100), the Science and Technology Project of Shanxi Province (No. 20150313007-5), and Applied Basic Research Programs of Shanxi Province (Grant No. 201801D121307 and 201801D221390). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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The scientific guarantor of this publication is Dengbin Wang.
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One of the authors (JR) is an employee of GE Healthcare. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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No complex statistical methods were necessary for this paper.
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Written informed consent was waived by the Institutional Review Board.
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• Retrospective
• Diagnostic or prognostic study
• Multicenter study
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Cui, Y., Liu, H., Ren, J. et al. Development and validation of a MRI-based radiomics signature for prediction of KRAS mutation in rectal cancer. Eur Radiol 30, 1948–1958 (2020). https://doi.org/10.1007/s00330-019-06572-3
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DOI: https://doi.org/10.1007/s00330-019-06572-3