Delta total tumor volume and radiomics as predictive biomarkers in microsatellite instability-high metastatic colorectal cancer

Combining delta-radiomics with delta-TTV enhanced performance, improving the RMST ratio from 2.215 to 2.450 (2.248-2.652,p=0.019), the AUC from 0.854 to 0.875 (0.862-0.888, p<0.001), and the C-index from 0.830 to 0.839 (0.819-0.841, p<0.001). Conclusion J o u r n a l P r e -p r o o fDelta-TTV is a robust early predictor of survival in MSI-H mCRC patients treated with immunotherapy.Integrating delta-radiomics further enhances prognostic accuracy and may support early treatment decision-making.