Prediction of outcome in patients with colorectal cancer (CRC) is challenging as a result of lack of a robust biomarker and heterogeneity between and within tumors. The aim of this review was to assess the current possibilities and limitations of radiomics (on computed tomography [CT], magnetic resonance imaging [MRI], and positron emission tomography [PET]) for the prediction of treatment outcome and long-term outcome in CRC. Medline/PubMed was searched up to August 2020 for studies that used radiomics for the prediction of response to treatment and survival in patients with CRC (based on pretreatment imaging). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and Radiomics Quality Score (RQS) were used for quality assessment. A total of 76 studies met the inclusion criteria and were included for further analysis. Radiomics analyses were performed on MRI in 41 studies, on CT in 30 studies, and on ¹⁸F-FDG-PET/CT in 10 studies. Heterogeneous results were reported regarding radiomics methods and included features. High-quality studies (n = 13), consisting mainly of MRI-based radiomics to predict response in rectal cancer, were able to predict response with good performance. Radiomics literature in CRC is highly heterogeneous, but it nonetheless holds promise for the prediction of outcome. The most evidence is available for MRI-based radiomics in rectal cancer. Future radiomics research in CRC should focus on independent validation of existing models rather than on developing new models.

由于缺乏可靠的生物标志物以及肿瘤之间和内部的异质性，结直肠癌 (CRC) 患者的预后预测具有挑战性。本综述的目的是评估放射组学（计算机断层扫描 [CT]、磁共振成像 [MRI] 和正电子发射断层扫描 [PET]）用于预测治疗结果和长期结果的当前可能性和局限性。 CRC。在 Medline/PubMed 中搜索了截至 2020 年 8 月的研究，这些研究使用放射组学来预测 CRC 患者的治疗反应和生存率（基于治疗前成像）。诊断准确性研究的质量评估 (QUADAS) 工具和放射组学质量评分 (RQS) 用于质量评估。共有 76 项研究符合纳入标准，并被纳入进一步分析。10 项研究中的¹⁸ F-FDG-PET/CT。报告了关于放射组学方法和包括特征的异质结果。高质量的研究（n = 13），主要包括基于 MRI 的放射组学来预测直肠癌的反应，能够以良好的性能预测反应。CRC 中的放射组学文献具有高度异质性，但它仍然有望预测结果。大多数证据可用于直肠癌中基于 MRI 的放射组学。CRC 未来的放射组学研究应侧重于对现有模型的独立验证，而不是开发新模型。