Image-based artificial intelligence for the prediction of pathological complete response to neoadjuvant chemoradiotherapy in patients with rectal cancer : a systematic review and meta-analysis

© 2024. Italian Society of Medical Radiology..

OBJECTIVE: Artificial intelligence (AI) holds enormous potential for noninvasively identifying patients with rectal cancer who could achieve pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT). We aimed to conduct a meta-analysis to summarize the diagnostic performance of image-based AI models for predicting pCR to nCRT in patients with rectal cancer.

METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search of PubMed, Embase, Cochrane Library, and Web of Science was performed from inception to July 29, 2023. Studies that developed or utilized AI models for predicting pCR to nCRT in rectal cancer from medical images were included. The Quality Assessment of Diagnostic Accuracy Studies-AI was used to appraise the methodological quality of the studies. The bivariate random-effects model was used to summarize the individual sensitivities, specificities, and areas-under-the-curve (AUCs). Subgroup and meta-regression analyses were conducted to identify potential sources of heterogeneity. Protocol for this study was registered with PROSPERO (CRD42022382374).

RESULTS: Thirty-four studies (9933 patients) were identified. Pooled estimates of sensitivity, specificity, and AUC of AI models for pCR prediction were 82% (95% CI: 76-87%), 84% (95% CI: 79-88%), and 90% (95% CI: 87-92%), respectively. Higher specificity was seen for the Asian population, low risk of bias, and deep-learning, compared with the non-Asian population, high risk of bias, and radiomics (all P < 0.05). Single-center had a higher sensitivity than multi-center (P = 0.001). The retrospective design had lower sensitivity (P = 0.012) but higher specificity (P < 0.001) than the prospective design. MRI showed higher sensitivity (P = 0.001) but lower specificity (P = 0.044) than non-MRI. The sensitivity and specificity of internal validation were higher than those of external validation (both P = 0.005).

CONCLUSIONS: Image-based AI models exhibited favorable performance for predicting pCR to nCRT in rectal cancer. However, further clinical trials are warranted to verify the findings.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:129

Enthalten in:

La Radiologia medica - 129(2024), 4 vom: 21. Apr., Seite 598-614

Sprache:

Englisch

Beteiligte Personen:

Shen, Hui [VerfasserIn]
Jin, Zhe [VerfasserIn]
Chen, Qiuying [VerfasserIn]
Zhang, Lu [VerfasserIn]
You, Jingjing [VerfasserIn]
Zhang, Shuixing [VerfasserIn]
Zhang, Bin [VerfasserIn]

Links:

Volltext

Themen:

Artificial intelligence
Deep-learning
Diagnostic imaging
Journal Article
Meta-Analysis
Meta-analysis
Pathologic complete response
Radiomics
Rectal neoplasms
Review
Systematic Review

Anmerkungen:

Date Completed 17.04.2024

Date Revised 17.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s11547-024-01796-w

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370022017