Multimodal data integration for biologically-relevant artificial intelligence to guide adjuvant chemotherapy in stage II colorectal cancer

作者：Chenyi Xie, Ziyu Ning, Ting Guo, Lisha Yao, Xiaobo Chen, Wanghong Huang, Suyun Li, Jiahui Chen, Ke Zhao, Xiuwu Bian, Zhenhui Li, Yanqi Huang, Changhong Liang, Qingling Zhang, Zaiyi Liu · 发表于：EBioMedicine · 年份：2025 · DOI：10.1016/j.ebiom.2025.105789 · 被引用次数：15 · 研究领域：AI in cancer detection、Radiomics and Machine Learning in Medical Imaging、Colorectal Cancer Surgical Treatments

Background Adjuvant chemotherapy provides a limited survival benefit (<5%) for patients with stage II colorectal cancer (CRC) and is suggested for high-risk patients. Given the heterogeneity of stage II CRC, we aimed to develop a clinically explainable artificial intelligence (AI)-powered analyser to identify radiological phenotypes that would benefit from chemotherapy. Methods Multimodal data from patients with CRC across six cohorts were collected, including 405 patients from the Guangdong Provincial People's Hospital for model development and 153 patients from the Yunnan Provincial Cancer Centre for validation. RNA sequencing data were used to identify the differentially expressed genes in the two radiological clusters. Histopathological patterns were evaluated to bridge the gap between the imaging and genetic information. Finally, we investigated the discovered morphological patterns of mouse models to observe imaging features. Findings The survival benefit of chemotherapy varied significantly among the AI-powered radiological clusters [interaction hazard ratio (iHR) = 5.35, (95% CI: 1.98, 14.41), adjusted P interaction = 0.012]. Distinct biological pathways related to immune and stromal cell abundance were observed between the clusters. The observation only (OO)-preferable cluster exhibited higher necrosis, haemorrhage, and tortuous vessels, whereas the adjuvant chemotherapy (AC)-preferable cluster exhibited vessels with greater pericyte coverage, allowing for a more enr...