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To investigate the value of a radiomics-based nomogram in predicting preoperative T staging of rectal cancer. A total of 268 eligible rectal cancer patients from August 2012 to December 2018 were enrolled and allocated into two datasets training (n = 188) and validation datasets (n = 8. Another set of 32 patients from January 2019 to July 2019 was included in a prospective analysis. Pretreatment T2-weighted images were used to radiomics features extraction. Feature selection and radiomics score (Rad-score) construction were performed th