With a new five-year, $2.78 million grant from the National Institutes of Health and National Cancer Institute, researchers at Case Western Reserve University (CWRU), Cleveland Clinic and University Hospitals (UH) will use artificial intelligence (AI) to better treat rectal cancer patients.

The American Cancer Society estimates about 46,000 people nationally will be diagnosed this year with rectal cancer—the third-most common type of cancer in the digestive system, after colon and pancreatic cancer.

By using AI, the researchers intend to derive specific metrics on magnetic resonance imaging (MRI) scans to better understand how rectal tumors are responding to therapy. The new information represents a key advance toward overcoming issues clinicians face in evaluating which tumors are dying or significantly regressing after therapy, and which are not.

“Our goal is to develop new types of radiomic signatures, involving computational analysis of radiology and pathology images, to determine how well these patients have responded to therapy,” said Satish Viswanath, an associate professor of biomedical engineering at Case Western Reserve and the grant’s lead researcher. “By doing so, doctors will be able to better personalize treatments for patients with rectal cancer.”

The study will analyze medical images from more than 900 rectal cancer patients using AI, a new biology-driven radiomics approach. The research will also include data collected in a previous clinical trial of rectal cancer patients.

Investigators will analyze how well patients respond to treatment based on the information gathered. Their goal is to develop a non-invasive and accurate method to identify rectal cancer patients who have no tumor remaining after therapy, reducing the number of unnecessary surgeries and associated complications for these patients.

“This study has great potential to help uncover signatures of dying tumors by mining characteristics that are usually invisible to the naked eye,” said Andrei S. Purysko, associate professor of radiology at Cleveland Clinic Lerner College of Medicine and co-principal investigator. “We will also be integrating AI with clinical evaluation to work out how to make AI signatures part of the clinical workflow.”

Viswanath’s team will lead the work with support from the new Center for AI Enabling Discovery in Disease Biology at the CWRU School of Medicine, bringing together medical science and AI.

School of Medicine Dean Stan Gerson recently announced the new center, also being co-led by Viswanath, as an extension to the school’s mission to improve human health through scientific discovery and education. 

“This study will bring real survival and quality-of-life benefits to our rectal cancer patients and is the first of many to come from the new center,” Gerson said. “This partnership proves how essential it is for medical institutions and disciplines to join forces and come up with new therapeutic methods for our cancer patients.”

Emily Steinhagen, a colorectal surgeon at University Hospitals Seidman Cancer Center and co-principal investigator, also leads the team with colleagues from the radiology, pathology, oncology, biostatistics and surgery departments at CWRU, Cleveland Clinic, UH and Medical College Wisconsin.

“The ability to accurately evaluate response to chemotherapy and radiation will help us personalize care by appropriately selecting them for non-operative management, and the findings of this study will help us improve outcomes for all patients being treated for rectal cancer,” Steinhagen said.