ASO Author Reflections: Radiopathomics Strategy of Combing Multi-scale Tumor Information on Pretreatment to Predict the
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ASO AUTHOR REFLECTIONS
ASO Author Reflections: Radiopathomics Strategy of Combing Multi-scale Tumor Information on Pretreatment to Predict the Pathologic Response to Neoadjuvant Therapy Jie Tian, PhD1,2,3,4
, Xinjuan Fan, MD5, Ruihua Xu, MD6, Ying-Shi Sun, MD7, and Guanyu Yang, PhD8
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; 2School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; 3Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China; 4Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China; 5 Department of Pathology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 6State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; 7Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/ Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing, China; 8School of Computer Science and Engineering, Southeast University, Nanjing, China 1
PAST The standard treatment for locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) and adjuvant chemotherapy.1 After nCRT, 15–27% of patients with LARC achieve a pathologic complete response (pCR) and usually have perfect long-term outcomes. These patients prefer to avoid surgery and preserve organs with a strategy such as ‘‘watch and wait’’ management.2 Additionally, for more than 50% of patients who cannot reach a good response (GR),3 treatment optimization according to different pathologic responses is essential to balance the benefits of nCRT against toxicity.4 Due to the advantages of radiomics for quantitative analysis of tumors,5 radiomics has demonstrated the potential of magnetic resonance imaging (MRI) in preoperative accurate evaluation of pCR6 or no response7 in previous studies. Furthermore, pretreatment multi-parameter magnetic resonance imaging (mp-MRI)-based radiomics was attempted to predict non-
Ó The Author(s) 2020 First Received: 20 May 2020 J. Tian, PhD e-mail: [email protected]
response to nCRT.8 However, to date, no nomogram has been established or acknowledged for predicting discrepancies in the response before nCRT. PRESENT In this study,9 981 consecutive patients with evaluation of response according to tumor regression grade (TRG) who received nCRT (primary cohort and external validation cohorts 1–3) were retrospectively recruited from four Chinese hospitals. Each recruited patient had received both a pretreatment multi-parametric magnetic resonance imaging (mp-MRI) and a whole-slide image (WSI) of biopsy specimens. Quantitative image features were extracted from the mp-MRI and WSI. These features then were used for radiopathomics signature (RPS) constru
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