Tian Mingke, Qin Fengying, Sun Xinyan, Pang Huiting, Yu Tao, Dong Yue
Department of Radiology, Cancer Hospital of Dalian University of Technology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, 110042, Liaoning, China.
Graduate School of Dalian Medical University, Dalian, China.
J Imaging Inform Med. 2025 Apr 18. doi: 10.1007/s10278-024-01371-9.
This study aimed to improve the accuracy of the diagnosis of lymph node metastasis (LNM) and prediction of patient prognosis in cervical cancer patients using a hybrid model based on MRI and clinical aspects. We retrospectively analyzed routine MR data from 485 patients with pathologically confirmed cervical cancer from January 2014 to June 2021. The data were divided into a training cohort (N = 261), internal cohort (N = 113), and external validation cohort (n = 111). A total of 2194 features were extracted from each ROI from T2WI and CE-T1WI. The clinical model (M1) was built with clinicopathological features including squamous cell carcinoma antigen, MRI-reported LNM, maximal tumor diameter (MTD). The radiomics model (M2) was built with four radiomics features. The hybrid model (M3) was constructed with squamous cell carcinoma antigen, MRI-reported LNM, MTD which consists of M1 and four radiomics features which consist of M2. GBDT algorithms were used to create the scores of M1 (clinical-score, C-score), M2 (radiomic score, R-score), and M3 (hybrid-score, H-score). M3 showed good performance in the training cohort (AUCs, M3 vs. M1 vs. M2, 0.917 vs. 0.830 vs. 0.788), internal validation cohorts (AUCs, M3 vs. M1 vs. M2, 0.872 vs. 0.750 vs. 0.739), and external validation cohort (AUCs, M3 vs. M1 vs. M2, 0.907 vs. 0.811 vs. 0.785). In addition, higher scores were significantly associated with worse disease-free survival (DFS) in the training cohort and the internal validation cohort (C-score, P = 0.001; R-score, P = 0.002; H-score, P = 0.006). Radiomics models can accurately predict LNM status in patients with cervical cancer. The hybrid model, which incorporates clinical and radiomics features, is a novel way to enhance diagnostic performance and predict the prognosis of cervical cancer.
本研究旨在使用基于MRI和临床因素的混合模型提高宫颈癌患者淋巴结转移(LNM)诊断的准确性及患者预后的预测能力。我们回顾性分析了2014年1月至2021年6月期间485例经病理证实的宫颈癌患者的常规MR数据。数据被分为训练队列(N = 261)、内部队列(N = 113)和外部验证队列(n = 111)。从T2WI和CE-T1WI的每个感兴趣区域(ROI)中总共提取了2194个特征。临床模型(M1)由包括鳞状细胞癌抗原、MRI报告的LNM、最大肿瘤直径(MTD)等临床病理特征构建而成。影像组学模型(M2)由四个影像组学特征构建而成。混合模型(M3)由M1中的鳞状细胞癌抗原、MRI报告的LNM、MTD以及M2中的四个影像组学特征构建而成。采用梯度提升决策树(GBDT)算法生成M1(临床评分,C评分)、M2(影像组学评分,R评分)和M3(混合评分,H评分)的分数。M3在训练队列(AUC,M3对M1对M2,0.917对0.830对0.788)、内部验证队列(AUC,M3对M1对M2,0.872对0.750对0.739)和外部验证队列(AUC,M3对M1对M2,0.907对0.811对0.785)中均表现出良好性能。此外,在训练队列和内部验证队列中,较高的分数与较差的无病生存期(DFS)显著相关(C评分,P = 0.001;R评分,P = 0.002;H评分,P = 0.006)。影像组学模型能够准确预测宫颈癌患者的LNM状态。结合临床和影像组学特征的混合模型是提高宫颈癌诊断性能和预测预后的一种新方法。
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