• MRI
• Positron emission tomography
• Radiology
• Rectal cancer

• Humans
• Rectal Neoplasms/therapy
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/pathology
• Neoadjuvant Therapy
• Middle Aged
• Male
• Female
• Magnetic Resonance Imaging
• Fluorodeoxyglucose F18
• Positron-Emission Tomography
• Aged
• Neoplasm Staging
• Radiopharmaceuticals
• Sensitivity and Specificity
• Retrospective Studies
• Treatment Outcome

• Tel Aviv University

• Computed tomography
• neoadjuvant chemoradiation
• radiomics feature
• rectal cancer

• neoadjuvant therapy
• pathological complete response
• rectal cancer
• trus-tcb

• Humans
• Rectal Neoplasms/pathology
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/therapy
• Neoadjuvant Therapy
• Male
• Female
• Middle Aged
• Prospective Studies
• Aged
• Image-Guided Biopsy/methods
• Adult
• Ultrasonography, Interventional
• Rectum/pathology
• Rectum/surgery
• Rectum/diagnostic imaging
• Predictive Value of Tests
• Treatment Outcome

• rectal cancer
• pathological complete response
• artificial intelligence
• machine learning

• Humans
• Pathologic Complete Response
• Rectal Neoplasms/surgery
• Rectum/pathology
• Prognosis
• Neoadjuvant Therapy/methods
• Retrospective Studies
• Neoplasm Staging

• T32 CA244125 NCI NIH HHS
• T32-CA244125 NIH HHS

• colorectal
• health disparities
• socioeconomic

• Female
• Humans
• Male
• Ethnicity
• Prospective Studies
• Rectal Neoplasms/therapy
• United States/epidemiology
• Clinical Trials as Topic
• Racial Groups
• Patient Selection

• ADC
• MRI
• chemoradiotherapy
• rectal cancer

• Humans
• Treatment Outcome
• Diffusion Magnetic Resonance Imaging
• Magnetic Resonance Imaging
• Chemoradiotherapy
• Neoadjuvant Therapy
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/therapy

• carbon nanoparticles suspension
• endoscopic ultrasound
• in situ resection
• neoadjuvant chemoradiotherapy
• rectal cancer

• Fujian Province Science and Technology Plan Project Natural Science Foundation in 2020
• Fujian Province Guiding Project in 2021

• Humans
• Immune Checkpoint Inhibitors
• Rectal Neoplasms
• Immunotherapy
• Brain Neoplasms
• Chemotherapy, Adjuvant
• Neoplasms, Second Primary

• F32 CA268703 NCI NIH HHS
• P50 CA236733 NCI NIH HHS
• T32 CA217834 NCI NIH HHS

• FDG-PET
• FDG-PET/CT
• MRI
• diagnostic value
• neoadjuvant therapy
• rectal cancer
• response

• Chemoradiotherapy
• Disease-Free Survival
• Humans
• Neoplasm Staging
• Rectal Neoplasms
• Retrospective Studies

The purpose of this study was to evaluate the diagnostic accuracy of artificial intelligence (AI) models with magnetic resonance imaging(MRI) in predicting pathological complete response(pCR) to neoadjuvant chemoradiotherapy (nCRT) in patients with rectal cancer. Furthermore, assessed the methodological quality of the models.

We searched PubMed, Embase, Cochrane Library, and Web of science for studies published before 21 June 2022, without any language restrictions. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) and Radiomics Quality Score (RQS) tools were used to assess the methodological quality of the included studies. We calculated pooled sensitivity and specificity using random-effects models, I² values were used to measure heterogeneity, and subgroup analyses to explore potential sources of heterogeneity.

We selected 21 papers for inclusion in the meta-analysis from 1562 retrieved publications, with a total of 1873 people in the validation groups. The meta-analysis showed that AI models based on MRI predicted pCR to nCRT in patients with rectal cancer: a pooled area under the curve (AUC) 0.91 (95% CI, 0.88-0.93), sensitivity of 0.82(95% CI,0.71-0.90), pooled specificity 0.86(95% CI,0.80-0.91). In the subgroup analysis, the pooled AUC of the deep learning(DL) model was 0.97, the pooled AUC of the radiomics model was 0.85; the pooled AUC of the combined model with clinical factors was 0.92, and the pooled AUC of the radiomics model alone was 0.87. The mean RQS score of the included studies was 10.95, accounting for 30.4% of the total score.

Radiomics is a promising noninvasive method with high value in predicting pathological response to nCRT in patients with rectal cancer. DL models have higher predictive accuracy than radiomics models, and combined models incorporating clinical factors have higher diagnostic accuracy than radiomics models alone. In the future, prospective, large-scale, multicenter investigations using radiomics approaches will strengthen the diagnostic power of pCR.

https://www.crd.york.ac.uk/prospero/, identifier CRD42021285630.

• Magnetic resonance tumor regression grade
• Non-radical management
• Rectal cancer

• Chemoradiotherapy
• Neoadjuvant therapy
• Non-operative management
• Rectal cancer
• Surgery
• Watchful waiting

• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Adenocarcinoma/therapy
• Aged
• Aged, 80 and over
• Capecitabine/administration & dosage
• Capecitabine/therapeutic use
• Chemoradiotherapy
• Female
• Fluorouracil/administration & dosage
• Fluorouracil/therapeutic use
• Humans
• Lymphatic Metastasis/pathology
• Male
• Middle Aged
• Neoadjuvant Therapy
• Radiotherapy Dosage
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Retrospective Studies
• Treatment Outcome
• Tumor Burden

Therapeutic strategies for patients with locally advanced rectal cancer (LARC) who are achieving a pathological complete response (pCR) after neoadjuvant radio-chemotherapy (neoCRT) are being increasingly investigated. Recent trials challenge the current standard therapy of total mesorectal excision (TME). For some patients, the treatment strategy of “watch-and-wait” seems a preferable procedure. The key factor in determining individual treatment strategies following neoCRT is the precise evaluation of the tumor response. Contrast-enhanced computer tomography (ceCT) has proven its ability to discriminate benign and malign lesions in multiple cancers. In this study, we retrospectively analyzed the ceCT based density of LARC in 30 patients, undergoing neoCRT followed by TME. We compared the tumors´ pre- and post-neoCRT density and correlated the results to the amount of residual vital tumor cells in the resected tissue. Overall, the density decreased after neoCRT, with the highest decrease in patients achieving pCR. Densitometry demonstrated a specificity of 88% and sensitivity of 68% in predicting pCR. Thus, we claim that ceCT based densitometry is a useful tool in identifying patients with LARC who may benefit from a “watch-and-wait” strategy and suggest further prospective studies.

• computer tomography
• locally advanced rectal cancer
• neoadjuvant chemoradiotherapy
• pathologic complete response
• predictive mode
• watch and wait

Neoadjuvant chemoradiotherapy (nCRT) has become the standard treatment for locally advanced rectal cancer (LARC). However, the accuracy of traditional clinical indicators in predicting tumor response is poor. Recently, radiomics based on magnetic resonance imaging (MRI) has been regarded as a promising noninvasive assessment method. The present study was conducted to develop a model to predict the pathological response by analyzing the quantitative features of MRI and clinical risk factors, which might predict the therapeutic effects in patients with LARC as accurately as possible before treatment.

A total of 82 patients with LARC were enrolled as the training cohort and internal validation cohort. The pre-CRT MRI after pretreatment was acquired to extract texture features, which was finally selected through the minimum redundancy maximum relevance (mRMR) algorithm. A support vector machine (SVM) was used as a classifier to classify different tumor responses. A joint radiomics model combined with clinical risk factors was then developed and evaluated by receiver operating characteristic (ROC) curves. External validation was performed with 107 patients from another center to evaluate the applicability of the model.

Twenty top image texture features were extracted from 6192 extracted-radiomic features. The radiomics model based on high-spatial-resolution T2-weighted imaging (HR-T2WI) and contrast-enhanced T1-weighted imaging (T1+C) demonstrated an area under the curve (AUC) of 0.8910 (0.8114–0.9706) and 0.8938 (0.8084–0.9792), respectively. The AUC value rose to 0.9371 (0.8751–0.9997) and 0.9113 (0.8449–0.9776), respectively, when the circumferential resection margin (CRM) and carbohydrate antigen 19-9 (CA19-9) levels were incorporated. Clinical usefulness was confirmed in an external validation cohort as well (AUC, 0.6413 and 0.6818).

Our study indicated that the joint radiomics prediction model combined with clinical risk factors showed good predictive ability regarding the treatment response of tumors as accurately as possible before treatment.

• magnetic resonance imaging
• neoadjuvant chemoradiotherapy
• rectal cancer
• tumor response

• Locally advanced rectal cancer
• Neoadjuvant therapy
• Reimaging
• Restaging

• Complete regression
• Preoperative chemoradiotherapy
• Response prediction

• chemoradiotherapy
• endoscopy
• magnetic resonance tumor regression grade
• rectal cancer
• tumor response
• ypt stage

• Aged
• Chemoradiotherapy/methods
• Endoscopy/methods
• Female
• Humans
• Magnetic Resonance Imaging/methods
• Male
• Middle Aged
• Multimodal Imaging
• Neoplasm Staging
• Organ Sparing Treatments
• Prospective Studies
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Treatment Outcome

• Complete pathologic response
• Neoadjuvant chemoradiation
• PET/CT
• Rectal Cancer

• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/mortality
• Adenocarcinoma/therapy
• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy
• Female
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local/diagnostic imaging
• Neoplasm Staging
• Philadelphia/epidemiology
• Positron Emission Tomography Computed Tomography
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/mortality
• Rectal Neoplasms/therapy
• Retrospective Studies

• P30 CA006927 NCI NIH HHS

• Complete response
• Local excision
• Rectal cancer
• Wait-and-see

To clarify the short- and long-term outcomes of radical surgery after neoadjuvant chemoradiotherapy (NCRT) with TS-1 and irinotecan, which enhances radiosensitivity, in patients with locally advanced rectal cancer.

The study group comprised 105 patients with locally advanced rectal cancer who received NCRT followed by radical surgery. NCRT consisted of pelvic radiotherapy (45 Gy in 25 fractions over a period of 5 weeks), S-1 (80 mg/m²) given concurrently for 25 days, and irinotecan (60 mg/m²), given once a week as a continuous intravenous infusion. Radical surgery was performed 8 weeks after treatment.

A pathological complete response was confirmed in 23.8%. The 5-year recurrence-free survival rate was 79.3%, and the 5-year overall survival rate was 87.1%. Multivariate analysis showed that the following 4 variables were independent predictors of recurrence-free survival: Sex (male: p = 0.0172), Pre-treatment tumor diameter (< 40 mm: p = 0.0223), Histopathological treatment response (grade 0,1: p = 0.0169), and ypN (ypN1: p = 0.1995; ypN2: p = 0.0007). Only ypN was an independent predictor of overall survival (ypN1: p = 0.0009; ypN2: p = 0.0012).

Our treatment strategy combining TS-1 with irinotecan to increase radiosensitivity had a high response rate.

• Neoadjuvant Chemoradiotherapy
• New treatment strategy
• Rectal Cancer

• rectal cancer
• chemotherapy
• chemoradiation
• non-operative management

• Adenocarcinoma/chemistry
• Adenocarcinoma/drug therapy
• Adenocarcinoma/pathology
• Adenocarcinoma/therapy
• Antineoplastic Combined Chemotherapy Protocols/adverse effects
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Biomarkers, Tumor
• Chemoradiotherapy
• Clinical Trials as Topic
• Dose Fractionation, Radiation
• Humans
• Meta-Analysis as Topic
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local/epidemiology
• Neoplasm Recurrence, Local/prevention & control
• Observational Studies as Topic
• Prognosis
• Radiation Injuries/epidemiology
• Radiation Injuries/etiology
• Radiation Injuries/prevention & control
• Radiotherapy/adverse effects
• Rectal Neoplasms/chemistry
• Rectal Neoplasms/drug therapy
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Remission Induction
• Survival Analysis
• Treatment Outcome

• P30 CA008748 NCI NIH HHS

• Colorectal cancer
• adjuvant chemotherapy
• immunotherapy
• molecular tests
• radioembolization
• sidedness
• surgery

• Age Factors
• Aged
• Algorithms
• Brachytherapy/methods
• Chemotherapy, Adjuvant
• Clinical Decision-Making/methods
• Comorbidity
• Decision Making
• Humans
• Patient Participation
• Rectal Neoplasms/radiotherapy
• Rectal Neoplasms/surgery

• P30 CA072720 NCI NIH HHS
• R50 CA275877 NCI NIH HHS

• Colorectal
• Complete response
• Neoadjuvant chemoradiotherapy
• Rectal cancer

• Rectal cancer
• lymph node
• neoadjuvant chemoradiotherapy
• pathological response
• risk factor

• Chemoradiotherapy
• Interval
• Pathological response
• Positron emission tomography
• Rectal cancer

• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Adenocarcinoma/therapy
• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy
• Female
• Fluorodeoxyglucose F18
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Positron-Emission Tomography/methods
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Retrospective Studies
• Time Factors
• Treatment Outcome

• Chemoradiotherapy
• Rectal neoplasms

• National Research Foundation of Korea

• local staging
• magnetic resonance imaging
• rectal cancer

• colorectal cancer
• esophageal cancer
• fluorodeoxyglucose (FDG)
• gastric cancer
• positron emission tomography/computed tomography (PET/CT)

• Animals
• Colorectal Neoplasms/diagnostic imaging
• Fluorodeoxyglucose F18/analysis
• Gastrointestinal Neoplasms/diagnostic imaging
• Humans
• Positron Emission Tomography Computed Tomography/methods
• Stomach Neoplasms/diagnostic imaging
• Tomography, X-Ray Computed/methods

• 3T MRI scanning
• Neoadjuvant chemoradiotherapy
• Rectal carcinoma
• Restaging

• Chemo-radiotherapy
• Locally advanced
• Neo-adjuvant
• Rectal cancer
• Surgery

We investigated the distribution of residual cancer cells (RCCs) within different layers of the bowel wall in surgical specimens and the value of biopsies of primary rectal lesion after preoperative volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients with rectal cancer. Between April 2011 and April 2013, 178 patients with rectal cancer who received preoperative VMAT, concurrent chemotherapy, and surgery were evaluated; 79 of the patients received a biopsy of the primary lesion after chemoradiotherapy and prior to surgery. The distribution of RCCs in the surgical specimens and the sensitivity and specificity of the biopsy of primary rectal lesions for pathological response were evaluated. Fifty-two patients had a complete pathological response in the bowel wall. Of the 120 patients with ypT2-4, the rate of detection of RCCs in the mucosa, submucosa, and muscularis propria was 20%, 36.7%, 69.2%, respectively. The sensitivity and specificity of biopsies of primary rectal lesions was 12.9% and 94.1%, respectively. After chemoradiotherapy, the RCCs were primarily located in the deeper layers of the bowel wall, and the biopsy results for primary rectal lesions were unreliable due to poor sensitivity.

• Neoadjuvant therapy
• Radiotherapy
• Rectal neoplasms
• Transanal endoscopic microsugery

• Colorectal neoplasms
• MRI, functional
• Molecular imaging
• Multimodal imaging
• Perfusion imaging