Insights into Imaging (Jul 2023)

Radiomic signatures from T2W and DWI MRI are predictive of tumour hypoxia in colorectal liver metastases

  • Zuhir Bodalal,
  • Nino Bogveradze,
  • Leon C. ter Beek,
  • Jose G. van den Berg,
  • Joyce Sanders,
  • Ingrid Hofland,
  • Stefano Trebeschi,
  • Kevin B. W. Groot Lipman,
  • Koen Storck,
  • Eun Kyoung Hong,
  • Natalya Lebedyeva,
  • Monique Maas,
  • Regina G. H. Beets-Tan,
  • Fernando M. Gomez,
  • Ieva Kurilova

DOI
https://doi.org/10.1186/s13244-023-01474-x
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 13

Abstract

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Abstract Background Tumour hypoxia is a negative predictive and prognostic biomarker in colorectal cancer typically assessed by invasive sampling methods, which suffer from many shortcomings. This retrospective proof-of-principle study explores the potential of MRI-derived imaging markers in predicting tumour hypoxia non-invasively in patients with colorectal liver metastases (CLM). Methods A single-centre cohort of 146 CLMs from 112 patients were segmented on preoperative T2-weighted (T2W) images and diffusion-weighted imaging (DWI). HIF-1 alpha immunohistochemical staining index (high/low) was used as a reference standard. Radiomic features were extracted, and machine learning approaches were implemented to predict the degree of histopathological tumour hypoxia. Results Radiomic signatures from DWI b200 (AUC = 0.79, 95% CI 0.61–0.93, p = 0.002) and ADC (AUC = 0.72, 95% CI 0.50–0.90, p = 0.019) were significantly predictive of tumour hypoxia. Morphological T2W TE75 (AUC = 0.64, 95% CI 0.42–0.82, p = 0.092) and functional DWI b0 (AUC = 0.66, 95% CI 0.46–0.84, p = 0.069) and b800 (AUC = 0.64, 95% CI 0.44–0.82, p = 0.071) images also provided predictive information. T2W TE300 (AUC = 0.57, 95% CI 0.33–0.78, p = 0.312) and b = 10 (AUC = 0.53, 95% CI 0.33–0.74, p = 0.415) images were not predictive of tumour hypoxia. Conclusions T2W and DWI sequences encode information predictive of tumour hypoxia. Prospective multicentre studies could help develop and validate robust non-invasive hypoxia-detection algorithms. Critical relevance statement Hypoxia is a negative prognostic biomarker in colorectal cancer. Hypoxia is usually assessed by invasive sampling methods. This proof-of-principle retrospective study explores the role of AI-based MRI-derived imaging biomarkers in non-invasively predicting tumour hypoxia in patients with colorectal liver metastases (CLM). Graphical Abstract

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