MRI Lymph Node Burden and Tumour Immunity in Rectal Cancer
Research type
Research Study
Full title
Association Between Lymph Node Count and Volume on Pre-operative MRI and Tumour-Infiltrating Lymphocytes in Rectal Cancer
IRAS ID
368767
Contact name
ADRIANA MARTINEZ
Contact email
Sponsor organisation
LONDON NORTH WEST UNIVERSITY HEALTHCARE NHS TRUST
Duration of Study in the UK
0 years, 8 months, 5 days
Research summary
This multi-centre retrospective observational cohort study will investigate whether lymph node count and lymph node volume measured on routine pre-operative MRI are associated with tumour-infiltrating lymphocyte (TIL) density in rectal adenocarcinoma.
Approximately 400 adult patients treated between 2010 and 2020 will be identified from institutional repositories at St Mark’s Hospital and collaborating centres. Eligible patients will have undergone curative-intent surgical resection without neoadjuvant therapy and will have available pre-operative staging MRI and archival tumour tissue.
Digitised histopathology slides (H&E, CD3, CD8) will undergo automated analysis using validated deep-learning pipelines to quantify tumour-infiltrating lymphocytes and infer microsatellite instability (MSI) status. Nuclear segmentation and cell classification will be performed using HoVer-NeXt, while tissue-type segmentation will identify tumour centre and invasive margin for standardised immune quantification. Pre-operative MRI scans will be systematically reviewed to determine lymph node count and total lymph node volume.
The primary outcome is the association between MRI lymph node metrics and TIL density. Analyses will adjust for relevant clinical, radiological, pathological, and molecular covariates.
The overarching objective is to determine whether MRI-visible lymph node burden reflects underlying tumour immune biology, enabling improved pre-operative risk stratification and more personalised rectal cancer management.
No direct patient contact will occur.
REC name
London - Surrey Research Ethics Committee
REC reference
26/PR/0259
Date of REC Opinion
19 Mar 2026
REC opinion
Favourable Opinion