Share:
Share this content in WeChat
X
Experience Exchang
Construction of prediction model of intermediate risk factors for early cervical cancer based on preoperative MRI radiomics and clinical features
YI Qinqin  ZHOU Zhou  LUO Yan  ZHONG Shuyuan  LING Rennan 

Cite this article as: Yi QQ, Zhou Z, Luo Y, et al. Construction of prediction model of intermediate risk factors for early cervical cancer based on preoperative MRI radiomics and clinical features[J]. Chin J Magn Reson Imaging, 2022, 13(4): 124-127, 136. DOI:10.12015/issn.1674-8034.2022.04.024.


[Abstract] Objective To establish and validate a combined predictive model based on pretreatment dual-sequence MR (T2 weighted imaging and contrast-enhanced T1 weighted imaging) imaging features and clinical features to predict intermediate risk factors in patients with early cervical cancer (ⅠB and ⅡA) less than 4 cm.Materials and Methods A total of 170 patients eligible for inclusion with cervical cancer from our hospital between 2016 and 2021 were retrospectively collected, and were divided into intermediate-risk and non-intermediate-risk groups based on postoperative pathological results. The cases were randomly divided into training group (n=119) and validation group (n=51) according to the ratio of 7:3. Analysis Kinetics software was used to extract radiomics characteristics. Multivariate Logistic regression analysis was used to develop the clinical model, the radiomics signature (Rad-score) and the clinical-radiomics model (the combined model). Performance of the three models were assessed by using receiver operating characteristic curves, calibration curves and decision curve analysis (DCA).Results The combined pretreatment clinical-radiomics model could predict intermediate-risk cervical cancer (AUC=0.853, P<0.01). Sensitivity of the clinical-radiomics model was 85.5% and specificity was 78%. The combined model showed better performance than clinical model and no significant difference compared with radiomics model.Conclusions The intermediate risk factors in early cervical cancer (ⅠB and ⅡA) less than 4 cm can be predicted with the combined clinical-radiomics model based on dual-sequence MRI and clinical characteristics. Therefore, it could benefit individualized treatment decision-making.
[Keywords] radiomics;cervical cancer;risk factors;magnetic resonance imaging;predicting model

YI Qinqin   ZHOU Zhou   LUO Yan   ZHONG Shuyuan   LING Rennan*  

Department of Radiology, Shenzhen People's Hospital (the Second Clinical Medical College of Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 508020, China

Ling RN, E-mail: 670744652@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Medical Scientific Research Foundation of Guangdong Province of China (No. B2020004).
Received  2021-12-21
Accepted  2022-03-25
DOI: 10.12015/issn.1674-8034.2022.04.024
Cite this article as: Yi QQ, Zhou Z, Luo Y, et al. Construction of prediction model of intermediate risk factors for early cervical cancer based on preoperative MRI radiomics and clinical features[J]. Chin J Magn Reson Imaging, 2022, 13(4): 124-127, 136. DOI:10.12015/issn.1674-8034.2022.04.024.

[1]
Cai ZJ, Liu Q. Understanding the Global Cancer Statistics 2018: implications for cancer control[J]. Sci China Life Sci, 2021, 64(6): 1017-1020. DOI: 10.1007/s11427-019-9816-1.
[2]
Koh WJ, Abu-Rustum NR, Bean S, et al. Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2019, 17(1): 64-84. DOI: 10.6004/jnccn.2019.0001.
[3]
Sedlis A, Bundy BN, Rotman MZ, et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group Study[J]. Gynecol Oncol, 1999, 73(2): 177-183. DOI: 10.1006/gyno.1999.5387.
[4]
Chu R, Zhang Y, Qiao X, et al. Risk stratification of early-stage cervical cancer with intermediate-risk factors: model development and validation based on machine learning algorithm[J]. Oncologist, 2021, 26(12): e2217-e2226. DOI: 10.1002/onco.13956.
[5]
Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: extracting more information from medical images using advanced feature analysis[J]. Eur J Cancer, 2012, 48(4): 441-446. DOI: 10.1016/j.ejca.2011.11.036.
[6]
Li XR, Xu C, Yu Y, et al. Prediction of lymphovascular space invasion using a combination of tenascin-C, cox-2, and PET/CT radiomics in patients with early-stage cervical squamous cell carcinoma[J]. BMC Cancer, 2021, 21(1): 866. DOI: 10.1186/s12885-021-08596-9.
[7]
Wang Y, Chen X, Pu H, et al. Roles of DWI and T2-weighted MRI volumetry in the evaluation of lymph node metastasis and lymphovascular invasion of stage ⅠB-ⅡA cervical cancer[J]. Clin Radiol, 2022, 77(3):224-230. DOI: 10.1016/j.crad.2021.12.011.
[8]
Huang YT, Chang CB, Yeh CJ, et al. Diagnostic accuracy of 3.0 T diffusion-weighted MRI for patients with uterine carcinosarcoma: assessment of tumor extent and lymphatic metastasis[J]. J Magn Reson Imaging, 2018. DOI: 10.1002/jmri.25981.
[9]
Yang Z, Xu WN, Ma YN, et al. (18)F-FDG PET/CT can correct the clinical stages and predict pathological parameters before operation in cervical cancer[J]. Eur J Radiol, 2016, 85(5): 877-884. DOI: 10.1016/j.ejrad.2016.02.010.
[10]
Wang W, Jiao YN, Zhang LC, et al. Multiparametric MRI-based radiomics analysis: differentiation of subtypes of cervical cancer in the early stage[J]. Acta Radiol, 2021: 2841851211014188. DOI: 10.1177/02841851211014188.
[11]
Deng XJ, Liu ML, Sun JQ, et al. Feasibility of MRI-based radiomics features for predicting lymph node metastases and VEGF expression in cervical cancer[J]. Eur J Radiol, 2021, 134: 109429. DOI: 10.1016/j.ejrad.2020.109429.
[12]
Wu YT, Ye S, Goswami S, et al. Clinical significance of peripheral blood and tumor tissue lymphocyte subsets in cervical cancer patients[J]. BMC Cancer, 2020, 20(1): 173. DOI: 10.1186/s12885-020-6633-x.
[13]
Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri[J]. Int J Gynaecol Obstet, 2018, 143(Suppl 2): 22-36. DOI: 10.1002/ijgo.12611.
[14]
Ren J, He YL, Li Y, et al. The value of model based on radiomics features of T2-weighted imaging and clinical feature in diagnosing the depth of stromal invasion of cervical squamous cell carcinoma[J]. Med J Peking Union Med Coll Hosp, 2021, 12(5): 705-712. DOI: 10.12290/xhyxzz.2021-0437.
[15]
Zhu J, Cao LJ, Wen H, et al. The clinical and prognostic implication of deep stromal invasion in cervical cancer patients undergoing radical hysterectomy[J]. J Cancer, 2020, 11(24): 7368-7377. DOI: 10.7150/jca.50752.
[16]
Fang J, Zhang B, Wang S, et al. Association of MRI-derived radiomic biomarker with disease-free survival in patients with early-stage cervical cancer[J]. Theranostics, 2020, 10(5): 2284-2292. DOI: 10.7150/thno.37429.
[17]
Wang JM, Wang Y, Huang YQ, et al. Prognostic values of platelet-associated indicators in resectable cervical cancer[J]. Dose Response, 2019, 17(3): 1559325819874199. DOI: 10.1177/1559325819874199.
[18]
Kozasa K, Mabuchi S, Komura N, et al. Comparison of clinical utilities of the platelet count and platelet-lymphocyte ratio for predicting survival in patients with cervical cancer: a single institutional study and literature review[J]. Oncotarget, 2017, 8(33): 55394-55404. DOI: 10.18632/oncotarget.19560.
[19]
Huang HP, Liu Q, Zhu LX, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer[J]. Sci Rep, 2019, 9(1): 3284. DOI: 10.1038/s41598-019-39150-0.
[20]
Han XP, Liu SY, Yang G, et al. Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: a systemic review, meta-analysis, and meta-regression of observational studies[J]. Gynecol Oncol, 2021, 160(1): 351-360. DOI: 10.1016/j.ygyno.2020.10.011.
[21]
Wu JY, Chen MY, Liang CX, et al. Prognostic value of the pretreatment neutrophil-to-lymphocyte ratio in cervical cancer: a meta-analysis and systematic review[J]. Oncotarget, 2017, 8(8): 13400-13412. DOI: 10.18632/oncotarget.14541.
[22]
Xiao ML, Ma FH, Li Y, et al. Multiparametric MRI-based radiomics nomogram for predicting lymph node metastasis in early-stage cervical cancer[J]. J Magn Reson Imaging, 2020, 52(3): 885-896. DOI: 10.1002/jmri.27101.
[23]
Manganaro L, Nicolino GM, Dolciami M, et al. Radiomics in cervical and endometrial cancer[J]. Br J Radiol, 2021, 94(1125): 20201314. DOI: 10.1259/bjr.20201314.
[24]
Umutlu L, Nensa F, Demircioglu A, et al. Radiomics analysis of multiparametric PET/MRI for N- and M-staging in patients with primary cervical cancer[J]. Rofo, 2020, 192(8): 754-763. DOI: 10.1055/a-1100-0127.
[25]
Li ZC, Li HL, Wang SY, et al. MR-based radiomics nomogram of cervical cancer in prediction of the lymph-vascular space invasion preoperatively[J]. J Magn Reson Imaging, 2019, 49(5): 1420-1426. DOI: 10.1002/jmri.26531.
[26]
Ai Y, Zhu HY, Xie CY, et al. Radiomics in cervical cancer: current applications and future potential[J]. Crit Rev Oncol Hematol, 2020, 152: 102985. DOI: 10.1016/j.critrevonc.2020.102985.
[27]
Du W, Wang Y, Li DD, et al. Preoperative prediction of lymphovascular space invasion in cervical cancer with radiomics-based nomogram[J]. Front Oncol, 2021, 11: 637794. DOI: 10.3389/fonc.2021.637794.
[28]
Yang Y, Feng F, Fu AY, et al. Radiomics nomogram based on T2WI and contrast-enhanced MRI for predicting lymphovascular space invasion in cervical squamous cell carcinoma[J]. Radiol Pract, 2021, 36(4): 494-501. DOI: 10.13609/j.cnki.1000-0313.2021.04.015.
[29]
Xie RL, Wang H, Tong SD, et al. The efficacy and safety of neoadjuvant therapy followed by radical surgery versus definite chemoradiotherapy in the treatment of ⅠB2-ⅡB cervical cancer: a meta-analysis[J]. Chin J Radiat Oncol, 2019, 28(6): 428-431. DOI: 10.3760/cma.j.issn.1004-4221.2019.06.007.
[30]
Zhou XL, Lai H, Wen XL, et al. Value of T2WI-FS based radiomics features in the diagnosis of cervical cancer metastasis and lymph vascular space invasion[J]. Chin J Magn Reson Imaging, 2021, 12(7): 69-71, 76. DOI: 10.12015/issn.1674-8034.2021.07.014.
[31]
Zhou H, Bai SM, Lin ZQ. Interpretation of NCCN guidelines to the clinical practice of cervical cancer in 2019(1st edition)[J]. Chin J Pract Gynecol Obstet, 2018, 34(9): 1002-1009. DOI: 10.19538/j.fk2018090114.

PREV Comparison of scores between PI-RADS v2.1 and PI-RADS v2 based on prostate slice-by-slice pathology
NEXT Analysis of the structure of normal female urethral sphincter complex and levator ani muscles by magnetic resonance diffusion tensor imaging
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn