IMR Press / CEOG / Volume 51 / Issue 4 / DOI: 10.31083/j.ceog5104081
Open Access Original Research
Multi-Parametric MRI Combined with Radiomics for the Evaluation of Lymphovascular Space Invasion in Cervical Cancer
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1 Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 210008 Nanjing, Jiangsu, China
2 Departments of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 210008 Nanjing, Jiangsu, China
3 Department of Interventional Radiology, The Second Affiliated Hospital of Bengbu Medical University, 233000 Bengbu, Anhui, China
4 The Comprehensive Cancer Centre of Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 210008 Nanjing, Jiangsu, China
5 Departments of Gynaecology and Obstetrics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 210008 Nanjing, Jiangsu, China
*Correspondence: zyzhou@nju.edu.cn (Zhengyang Zhou); jsource80@163.com (Yuan Jiang); jullysaki@163.com (Li Zhu)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2024, 51(4), 81; https://doi.org/10.31083/j.ceog5104081
Submitted: 10 October 2023 | Revised: 4 January 2024 | Accepted: 12 January 2024 | Published: 25 March 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: To explore the feasibility of radiomic models using different magnetic resonance imaging (MRI) sequences combined with clinical information in evaluating the status of lymphovascular space invasion (LVSI) in cervical cancer. Methods: One hundred one cervical cancer patients were included from January 2018 to December 2020. All patients underwent 3.0T MRI examination including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI) and contrast-enhanced T1 weighted imaging (T1WI + C) enhanced sequences. Age, preoperative squamous cell carcinoma (SCC) associated antigen value and the depth of muscular invasion were collected. The 101 patients were divided into training set and validation set. Three different models were developed using T2WI, DWI and T1WI + C parameters respectively. One model was developed combining the three different sequences. The diagnostic performance of each model was compared via receiver operating characteristic curve analysis. Results: Forty-eight cases were pathologically confirmed with lymphovascular space invasion. The average SCC value of the LVSI positive group (10.82 ± 20.11 ng/mL) was higher than that of the negative group (6.71 ± 14.45 ng/mL), however there was no significant statistical difference between the two groups. No clinical or traditional imaging features were selected by spearman correlation analysis. Among the corresponding radiomic models, the machine learning model based on multi-modality showed the best diagnostic efficiency in the evaluation of LVSI (receiver operating characteristic (ROC) curve of multimodal radiomics in the training set (area under the ROC curve (AUC) = 0.990 (0.975–0.999)) and in the validation set (AUC = 0.832 (0.693–0.971)). Conclusions: The diagnostic efficacy of radiomics is superior to conventional MRI parameters and clinical parameters. The radiomics-based machine learning model can help improve accuracy for the preoperative evaluation of LVSI in cervical cancer.

Keywords
cervical cancer
lymphovascular space invasion
machine learning
magnetic resonance imaging
radiomics
Funding
ZKX 20024/Key project foundation of Nanjing for the development of medical technology
Figures
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