Speaker
Carlo Mancini Terracciano
(ROMA1)
Description
The therapy for locally advanced rectal cancers is: neoadjuvant chemo-radiotherapy (CRT) followed by radical surgery. Although the local pelvic recurrence rate is lower than 10%, this therapeutic approach is an over-treatment of the patients who completely respond (CR) to CRT. Indeed, CR could benefit from either less invasive surgery (ie, transanal endoscopic microsurgery) or “wait-and-watch” strategy. Also the patients who do not respond to the treatment (non-responders, NR) whose early identification (2–3 weeks after the start of neoadjuvant CRT) might help clinicians in referring them to alternative treatments.
Magnetic Resonance (MR) Imaging is the gold standard for preoperative staging and re-staging of rectal cancer. However, it is hard to asses the CRT patient response only on the basis of the MR images visual inspection.
With the aim of discriminating CR and NR patients prior or immediately after the start of CRT, we developed a Texture Analysis (TA) of T2 weighted MR images of the entire volume of rectal cancer acquired before, during and after the treatment of 55 patients with a 3 T MR. All the patients had a histologically confirmed rectal adenocarcinoma and locally advanced tumour stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0).
The extracted TA parameters have been used to build a classifier using multivariate analysis, it allows to discriminate CR with an area of the Receiver Operating Characteristic (ROC) curve of 0.94 and NR with a ROC curve area of 0.86.
Primary author
Carlo Mancini Terracciano
(ROMA1)
Co-authors
Andrea Laghi
(Policlinico Umberto I, Sapienza University of Rome, Rome, Italy)
Andrea Russomando
(ROMA1)
Cecilia Voena
(ROMA1)
Marcella Ianniti
(Policlinico Umberto I, Sapienza University of Rome, Rome, Italy)
Riccardo Faccini
(ROMA1)
Riccardo Ferrari
(Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy)
Riccardo Paramatti
(ROMA1)
Valerio Marè
(Dipartimento di Fisica, Sapienza Universita` di Roma, Roma, Italy)
