Trial reportEuropean radiology2022
Response prediction of neoadjuvant chemoradiation therapy in locally advanced rectal cancer using CT-based fractal dimension analysis.
Trial report in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- 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.La Radiologia medica · 2024Pooled it
- Interpretable machine learning models based on CT radiomics for predicting chemoradiotherapy response in rectal cancer.BMC medical imaging · 2026Article
- Diagnostic efficacy of dual-energy computed tomography-based fractal analysis for assessing extramural venous invasion/tumor deposits and peripheral nerve invasion in rectal cancer.Quantitative imaging in medicine and surgery · 2026Article
- Application of fractal dimension combined with radiomics and clinical scores in recurrence prediction of atrial fibrillation after radiofrequency ablation.Frontiers in cardiovascular medicine · 2026Article
- Artificial intelligence and computational prediction models for risk stratification, treatment response, and outcomes in colorectal cancer: a narrative review.Frontiers in oncology · 2026Review
- Fractal analysis of longitudinal MRI for predicting response to neoadjuvant chemotherapy in breast cancer.NPJ precision oncology · 2025Article
- Magnetic resonance imaging fractal analysis of O(6)-methylguanine-DNA methyltransferase promoter methylation status in isocitrate dehydrogenase wild-type glioblastoma.Quantitative imaging in medicine and surgery · 2025Article
- Quantifying tumor morphological complexity based on pretreatment MRI fractal analysis for predicting pathologic complete response and survival in breast cancer: a retrospective, multicenter study.Breast cancer research : BCR · 2025Article
- Feasibility of ADC histogram analysis for predicting of postoperative recurrence in aggressive spinal tumors.Journal of bone oncology · 2025Article
- Simulated deep CT characterization of liver metastases with high-resolution filtered back projection reconstruction.Visual computing for industry, biomedicine, and art · 2024Article
- Current implications and challenges of artificial intelligence technologies in therapeutic intervention of colorectal cancer.Exploration of targeted anti-tumor therapy · 2023Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThere are individual variations in neo-adjuvant chemoradiation therapy (nCRT) in patients with locally advanced rectal cancer (LARC). No reliable modality currently exists that can predict the efficacy of nCRT. The purpose of this study is to assess if CT-based fractal dimension and filtration-histogram texture analysis can predict therapeutic response to nCRT in patients with LARC.
methodsIn this retrospective study, 215 patients (average age: 57 years (18-87 years)) who received nCRT for LARC between June 2005 and December 2016 and underwent a staging diagnostic portal venous phase CT were identified. The patients were randomly divided into two datasets: a training set (n = 170), and a validation set (n = 45). Tumor heterogeneity was assessed on the CT images using fractal dimension (FD) and filtration-histogram texture analysis. In the training set, the patients with pCR and non-pCR were compared in univariate analysis. Logistic regression analysis was applied to identify the predictive value of efficacy of nCRT and receiver operating characteristic analysis determined optimal cutoff value. Subsequently, the most significant parameter was assessed in the validation set.
resultsOut of the 215 patients evaluated, pCR was reached in 20.9% (n = 45/215) patients. In the training set, 7 out of 37 texture parameters showed significant difference comparing between the pCR and non-pCR groups and logistic multivariable regression analysis incorporating clinical and 7 texture parameters showed that only FD was associated with pCR (p = 0.001). The area under the curve of FD was 0.76. In the validation set, we applied FD for predicting pCR and sensitivity, specificity, and accuracy were 60%, 89%, and 82%, respectively.
conclusionFD on pretreatment CT is a promising parameter for predicting pCR to nCRT in patients with LARC and could be used to help make treatment decisions. KEY POINTS: • Fractal dimension analysis on pretreatment CT was associated with response to neo-adjuvant chemoradiation in patients with locally advanced rectal cancer. • Fractal dimension is a promising biomarker for predicting pCR to nCRT and may potentially select patients for individualized therapy.
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