Prediction of lymph node metastasis after neoadjuvant chemoradiotherapy in rectal cancer with multiparametric MRI-based radiomics

Motivation: A precise assessment of LN restaging following nCRT is important to guide therapeutic decision and predict prognosis for LARC patients. Goal(s): To develop and validate a predictive radiomics model for assessing LNM status after nCRT in LARC. Approach: This study enrolled 150 LARC patients from two centers and constructed several radiomics models based on T2WI and DWI before or/and after nCRT to assess LNM after nCRT. Results: The multiparametric model incorporating MR radiomics features prior to and after nCRT was superior to the clinical model, modelpre_T2_DWI and the single-sequence models (external validation cohort AUC 0.831). Impact: Radiomics analysis of pre- and post-nCRT multiparameter MR images could predict LNM after nCRT in patients with LARC, and might help guide therapies and predict prognosis for LARC patients.