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News — CLEVELAND—With a new four-year, $1.14 million grant from the researchers at and the , will use artificial intelligence (AI) to determine the best personalized treatment for Veterans with rectal cancer.

Colorectal cancers are the third-most common type of cancer in military personnel, affecting up to 8% of Veterans and 5% of active-duty Service members, according to the More than 152,000 patients in the United States will be diagnosed with colorectal cancer in 2024, with more than 46,000 localized to the rectum, according to the ACS.

, co-director of the at Case Western Reserve and a biomedical engineer and research scientist at the Cleveland VA Medical Center, along with VA co-investigators, plan to use AI to develop an algorithm that analyzes magnetic resonance imaging (MRI) scans to better understand how rectal tumors respond to treatment.

The AI tool, called the computational image Rectal Response Classifier (ciRRC), will assess MRI data in more detail than human evaluation alone. The hope is the tool, once fully developed and tested, will allow doctors to offer Veterans timely customized precision oncology treatment.

“Rectal cancer patients undergo a one-size-fits-all treatment protocol that almost always requires surgery, but surgery comes with inherent risks and complications, including patients having a worse quality of life,” said Eric Marderstein, co-investigator and section chief of general and colorectal surgery at the Cleveland VA Medical Center. “We urgently need better markers to assess the risk of metastasis and invasion so patients can be recommended additional therapy to maximize their chance of survival.”

With the advent of newer combinations of treatments, like chemotherapy and radiation therapy, doctors could use ciRRC to determine whether a patient may be resistant to a specific treatment regimen. They could then offer different options to help patients avoid complications and decide the level of treatment.

The study also includes a unique multi-institutional validation of ciRRC across Midwest VA Medical Centers to expand its potential impact.

“Time is of the essence, especially for Veterans who tend to be older than other rectal cancer patients,” Viswanath said. “Our project addresses this critical need to improve outcomes and quality of life for Veterans.”                     

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