Embodiments discussed herein facilitate determination of responsiveness to chemoradiation treatment in rectal cancer patients based on structural deformation features obtained from a pre- or post-treatment medical imaging. One example embodiment can perform operations comprising: accessing an image volume of a rectum comprising a rectal tumor; generating a forward mapping based on non-rigidly registering a healthy rectal atlas to the image volume; inverting the forward mapping to generate an inverse mapping from the image volume to the healthy rectal atlas; determining, based on the inverse mapping, an associated deformation magnitude for each voxel of a plurality of voxels associated with the rectum; computing one or more structural deformation features based on the associated deformation magnitudes for the plurality of voxels; and predicting via a classifier whether or not the rectal tumor will respond to the chemoradiation treatment based at least in part on the one or more structural deformation features.
Structural rectal atlas deformation features for characterizing intra-wall and peri-wall chemoradiation response on magnetic resonance imaging (MRI)