Preoperative prediction of parametrial invasion of stage ⅠB-ⅡB cervical cancer by intratumoural and peritumoural MRI radiomics
Objective To establish a comprehensive model based on sagittal T2-weighted imaging(T2WI)combined with different peritumoral characteristics and clinical risk factors for the prediction of parametrial invasion in stage ⅠB-ⅡB cervical cancer.Methods Confirmed by postoperative pathology,a total of 180 patients with stage ⅠB-ⅡB cervical cancer were enrolled from Xixian Campus of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2018 to April 2024.All the patients they received preoperative MRI examination and radical hysterectomy with systematic pelvic lymph node dissection and retrospectively analyzed.The radiomics features were extracted from the volumetric region of interest of the tumor(ROI)and 1 mm-,2 mm-,3 mm-,4 mm-,5 mm-,6 mm-peritumoural rings(ROI-1,ROI-2,ROI-3,ROI-4,ROI-5,ROI-6)of the sagittal T2WI,respectively,and were selected by Pearson analysis and LASSO regression.Different feature-based radiomics models were independently built and their predictive performances were compared to select the optimal ones.Finally,the comprehensive model was developed based on optimal radiomics characteristics and clinical independent risk factors.And the predictive performance,calibration degree and application value of the models were evaluated by the ROC curve,calibration curves and the decision curve analysis(DCA).Results Four effective radiomics features,obtained from the peritumoral regions with 3 mm distances,had the best predictive performance,achieving an AUC of 0.980 and 0.770 in the training and internal validation cohorts,respectively.The maximum tumor diameter and platelet count were identified as independent clinical risk factors.The clinical model established by maximum tumor diameter and platelet count had the second predictive performance,with AUC of 0.860 and 0.673,respectively.The combined model constructed by integrating independent risk factors and four effective radiomics features from the peritumoral regions with 3 mm distances had more stable predictive performance,with an AUC of 0.952 and 0.939,respectively.After calibration curve and decision curve analysis,the intratumoral binding 3 mm around the tumor omics model had higher calibration degree and greater clinical net benefit.Conclusion The combined model based on intratumoral peritumoral radiomics and clinical parameters of MRI can better predict the preoperation of stage ⅠB-ⅡB cervical cancer,which has important clinical significance for guiding the individualized treatment of patients.
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维普
