Evidence map›Paper›PMID 41606201›Full record

ArticleUpdates in surgery2026

Radiomics of portal-phase ring enhancement: a novel imaging biomarker for bevacizumab response associated with overall survival rates. It might help with surgical decision-making in colorectal liver metastases?

Maria Chiara Brunese, Alfredo Clemente, Marco De Chiara, Valerio Nardone, Salvatore Spiezia, Pasquale Avella, Erika Martinelli, Maria Giovanna Chini, Fabrizio Urraro, Alfonso Reginelli and 2 more

Erratum issuedAbstract read
In one paragraph

Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Maria Chiara BruneseDepartment of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy.
Alfredo ClementeRadiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy. alfredo.clemente@unicampania.it.
Marco De ChiaraDepartment of Life Sciences, Health and Health Professions, Link Campus University, 00165, Rome, Italy.
Valerio NardoneRadiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
Salvatore SpieziaDepartment of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy. salvatorespiezia00@gmail.com.
Pasquale AvellaDepartment of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy.
Erika MartinelliMedical Oncology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131, Naples, Italy.
Maria Giovanna ChiniDepartment of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy.
Fabrizio UrraroRadiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
Alfonso Reginelli *Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
Salvatore Cappabianca *Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
ROI Segmentation Collaborative Group

Funding

Regione Molise Ministero delle Imprese e del Made in ItalyRegione Molise Progetto MolisCTEUniversità degli Studi del Molise National Plan for NRRP Complementary Investments D3 4 Health: Digital Driven DiagnosticsUniversità degli Studi del Molise prognosticsUniversità degli Studi del Molise therapeutics for sustainable Health care.
6 · The paper itself

Abstract

The liver is the most common site of metastases from colorectal cancer (CRC), affecting up to half of patients throughout their disease course. Although contrast-enhanced computed tomography (CECT) is routinely used for staging and treatment monitoring, RECIST criteria poorly reflect biological heterogeneity and antiangiogenic therapy effects. Integrating radiological and radiomic biomarkers may enhance response evaluation and personalized treatment. This study aimed to evaluate portal-phase ring enhancement as a potential imaging biomarker of disease progression and prognosis in patients with colorectal liver metastases (CRLM) treated with bevacizumab-based chemotherapy and to explore its correlation with CT-derived radiomic features. Eighty consecutive patients with histologically confirmed CRLM treated with standard chemotherapy plus bevacizumab were retrospectively analyzed. Baseline and 3-month CECT scans were evaluated for the presence and evolution of portal-phase ring enhancement. Radiomic features were extracted and correlated with morphologic patterns, while survival outcomes were assessed using Kaplan-Meier and logistic regression analyses. Baseline portal-phase ring enhancement was observed in 32.5% of patients and was significantly associated with inferior overall survival (p = 0.001), a finding confirmed on follow-up imaging (p = 0.016). Among radiomic features, sphericity showed the strongest correlation with ring enhancement (p = 0.003), yielding a modestly discriminative model. Portal-phase ring enhancement represents a reproducible imaging biomarker of poor prognosis in bevacizumab-treated CRLM. Its correlation with distinct radiomic signatures reinforces its biological plausibility as a marker of tumor aggressiveness. Integrating this feature with shape-based metrics into early imaging evaluation may refine risk stratification and personalized management.

Indexed as

Antineoplastic Agents, ImmunologicalBevacizumabClinical Decision-MakingColorectal NeoplasmsLiver NeoplasmsRadiomicsTomography, X-Ray ComputedAdultAgedBiomarkersBiomarkers, TumorFemaleHumansMaleMiddle AgedPrognosisAntineoplastic Agents, ImmunologicalBevacizumabBiomarkersBiomarkers, TumorBevacizumab-based chemotherapyColorectal liver metastases (CRLM)Portal phase ring enhancementPrognostic imaging biomarkersRadiomics

Identifiers

PMID41606201
PMCPMC13212809

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.