## 4 Results and Discussion
### Discussion
Regarding the clinical implications, this technique does not aspire to replace the biopsy, but rather to combine it, both to provide valuable data for decision-making regarding other possible diagnostic processes and to increase the information available to decide on the possible alternatives for treatment, establish the prognosis, or follow up on patients with colorectal cancer [35]. As we have previously pointed out, it has been described that the mutation in the KRAS oncogene must be confirmed in patients with colorectal cancer, since its presence determines a worse response to anti-EGFR treatments. The radiological images prior to any treatment on the tumour can be of great help in the treatment of patients with colorectal cancer, since from the first moment of diagnosis they can predict the presence or absence of the mutation, and therefore they can focus treatment from the beginning, without the need to wait for a confirmatory biopsy or pathological analysis of the surgical specimen (in case the first treatment performed is resective surgery). This determination of the presence of the KRAS oncogene in a bloodless manner through the use of imaging techniques, can lead to a reduction in the time limits in the process of diagnosis and treatment of patients with colorectal cancer. In addition, as pointed out in this study, the analysis using imaging techniques is intended to be an analysis of the entire tumour piece, which is an advantage over the analysis of a biopsy, which only covers a small part of the tumour. This is of paramount importance in patients who are not undergoing initial resective treatment and who require a histological analysis of the tumour to determine the presence or absence of the mutation. On the other hand, the results obtained in the studies carried out are still not as categorical as the ones provided by histological methods, therefore, this technique is not yet in a position to compete with the gold standard for this indication. However, pending a development that will surely come with the frenetic advance in this field, imaging techniques can provide a valuable additional information, such as determining the areas of the tumour most likely to be biopsied for being suspicious of mutation in KRAS, since we know that this mutation is not distributed homogeneously by all the tumour cells. Another possible use of it is in the follow-up of patients already treated, trying to make a diagnosis as early as possible of a tumour recurrence or of a non-response to primary treatment. The goal of the current paper was to present a viability analysis to test if texture features and machine learning techniques were able to predict the genetic disorder KRAS from CT images. The obtained results are encouraging and even better than similar studies [27; 28; 29; 30; 31]. Nonetheless, a possible limitation is the low sample size our study has been conducted with (i.e., 47 patients). Therefore, it is necessary to carry out further validation with more patients in future studies. Moreover, in future works, we will tackle the compliance in implementation of the features used in this study with the image biomarker standardisation initiative (IBSI) [36], and even a comparison with them. Conceptualization, M.S.-B. and E.C. ; data curation, E.H., J.P. and J.R.A. ; methodology, E.C., V.G.-C. and M.S.-B. ; software, V.G.-C., E.C. and M.F.-D.; validation, V.G.-C., E.C. and M.F.-D.; formal analysis, M.F.-D., E.H., J.R.A. and J.P.; investigation, V.G.-C. and E.H.; resources, M.S.-B., J.R.A. and E.H., writing--original draft preparation, E.C. and M.S.-B. ; writing--review and editing, V.G.-C.; visualization, J.P.; supervision, E.C. and M.S.-B. ; project administration, M.S.-B. All authors have read and agreed to the published version of the manuscript. This research received no external funding. This work has received financial support from the Xunta de Galicia (Centro singular de investigacion de Galicia, accreditation 2020-2023) and the European Union (European Regional Development Fund--ERDF), Project MTM2016-76969-P.