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Radiomic biomarkers in amultivariate analyze for predicting outcome in locally advanced rectal cancer

Camil Ciprian MIRESTEAN., Ovidiu PAGUTE., Ramona ROMAN., Alexandru Dumitru ZARA., Calin BUZEA., Roxana Irina IANCU and DragosTeodor IANCU

Tumor regression grade (TRG) is a predictor factor response to multimodal neo-adjuvant treatment in rectal cancer (chemo-radiotherapy followed by curative resection). DWORAK TRG score is considered a good predictor of disease free survival (DFS). Despite a correctly applied multimodal treatment, only 20% of the patients will have complete tumor regression (complete pathological response) while 20-40% will experience no regression or progressive disease on the surgical sample. The purpose of these study is to identify in a multivariate analysis the clinical, pathological and imagistic predictors and to identify possible correlations between the radiomics markers (Haussdorf distance for tumor contours, grey level matrix analysis), the length and volume of the tumor and mesorectum, pathological biomarkers (lymphovascular an perineural invasion) and the response to the neoadjuvant therapy evaluated by DWORAK TRG score. One of the major challenge in the use of radiomics is the standardization of acquisitions. Although IRM imaging is considered superior in the evaluation of rectal tumors extention, the use for computerized image processing of data obtained from CT-planning simulation for radiotherapy was preferred for uniformity in the acquisition of CT data. Radiomic computerized imaging analysis can become a non-invasive method that will identify "bad responders" to neoadjuvant treatment and will select patients requiring an intensification of preoperative treatment.

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