{"ID":2849748,"CreatedAt":"2026-06-01T04:54:23.091178241Z","UpdatedAt":"2026-06-01T04:54:23.091178241Z","DeletedAt":null,"paper_url":"https://arxiv.org/abs/2510.23687","arxiv_id":"2510.23687","title":"Gut decisions based on the liver: A radiomics approach to boost colorectal cancer screening","abstract":"Non-invasive colorectal cancer (CRC) screening represents a key opportunity to improve colonoscopy participation rates and reduce CRC mortality. This study explores the potential of the gut-liver axis for predicting colorectal neoplasia through liver-derived radiomic features extracted from routine CT images as a novel opportunistic screening approach. In this retrospective study, we analyzed data from 1,997 patients who underwent colonoscopy and abdominal CT. Patients either had no colorectal neoplasia (n=1,189) or colorectal neoplasia (n_total=808; adenomas n=423, CRC n=385). Radiomics features were extracted from 3D liver segmentations using the Radiomics Processing ToolKit (RPTK), which performed feature extraction, filtering, and classification. The dataset was split into training (n=1,397) and test (n=600) cohorts. Five machine learning models were trained with 5-fold cross-validation on the 20 most informative features, and the best model ensemble was selected based on the validation AUROC. The best radiomics-based XGBoost model achieved a test AUROC of 0.810, clearly outperforming the best clinical-only model (test AUROC: 0.457). Subclassification between colorectal cancer and adenoma showed lower accuracy (test AUROC: 0.674). Our findings establish proof-of-concept that liver-derived radiomics from routine abdominal CT can predict colorectal neoplasia. Beyond offering a pragmatic, widely accessible adjunct to CRC screening, this approach highlights the gut-liver axis as a novel biomarker source for opportunistic screening and sparks new mechanistic hypotheses for future translational research.","short_abstract":"Non-invasive colorectal cancer (CRC) screening represents a key opportunity to improve colonoscopy participation rates and reduce CRC mortality. This study explores the potential of the gut-liver axis for predicting colorectal neoplasia through liver-derived radiomic features extracted from routine CT images as a novel...","url_abs":"https://arxiv.org/abs/2510.23687","url_pdf":"https://arxiv.org/pdf/2510.23687v1","authors":"[\"Anna Hinterberger\",\"Jonas Bohn\",\"Dasha Trofimova\",\"Nicolas Knabe\",\"Julia Dettling\",\"Tobias Norajitra\",\"Fabian Isensee\",\"Johannes Betge\",\"Stefan O. Schönberg\",\"Dominik Nörenberg\",\"Sergio Grosu\",\"Sonja Loges\",\"Ralf Floca\",\"Jakob Nikolas Kather\",\"Klaus Maier-Hein\",\"Freba Grawe\"]","published":"2025-10-27T17:03:15Z","proceeding":"q-bio.QM","tasks":"[\"q-bio.QM\",\"eess.IV\"]","methods":"[]","has_code":false}