CT-radiomics and pathological tumor response to systemic therapy: A predictive analysis for colorectal liver metastases. Development and internal validation of a clinical-radiomic model

The standard treatment of colorectal liver metastases (CRLM) is surgery with perioperative chemotherapy. A tumor response to systemic therapy confirmed at pathology examination is the strongest predictor of survival, but it cannot be adequately predicted in the preoperative setting. This bi-institutional retrospective study investigates whether CT-based radiomics of CRLM and peritumoral tissue provides a reliable non-invasive estimation of the pathological tumor response to chemotherapy. All consecutive patients undergoing liver resection for CRLM at the two institutions were considered. Only patients with a radiological partial response or stable disease at chemotherapy and with a preoperative/post-chemotherapy CT performed