Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
MRI ‐based radiomic signatures for pretreatment prognostication in cervical cancer
Ist Teil von
Cancer medicine (Malden, MA), 2023-10, Vol.12 (20), p.20251-20265
Ort / Verlag
Bognor Regis: John Wiley & Sons, Inc
Erscheinungsjahr
2023
Link zum Volltext
Quelle
Wiley Online Library
Beschreibungen/Notizen
Abstract
Background
Accurate pretherapeutic prognostication is important for tailoring treatment in cervical cancer (CC).
Purpose
To investigate whether pretreatment MRI‐based radiomic signatures predict disease‐specific survival (DSS) in CC.
Study Type
Retrospective.
Population
CC patients (
n
= 133) allocated into training
(T)
(
n
T
= 89)/validation
(V)
(
n
V
= 44) cohorts.
Field Strength/Sequence
T2‐weighted imaging (T2WI) and diffusion‐weighted imaging (DWI) at 1.5T or 3.0T.
Assessment
Radiomic features from segmented tumors were extracted from T2WI and DWI (high
b
‐value DWI and apparent diffusion coefficient (ADC) maps).
Statistical Tests
Radiomic signatures for prediction of DSS from T2WI (T2
rad
) and T2WI with DWI (T2 + DWI
rad
) were constructed by least absolute shrinkage and selection operator (LASSO) Cox regression. Area under time‐dependent receiver operating characteristics curves (AUC) were used to evaluate and compare the prognostic performance of the radiomic signatures, MRI‐derived maximum tumor size ≤/> 4 cm (MAX
size
), and 2018 International Federation of Gynecology and Obstetrics (FIGO) stage (I–II/III–IV). Survival was analyzed using Cox model estimating hazard ratios (HR) and Kaplan–Meier method with log‐rank tests.
Results
The radiomic signatures T2
rad
and T2 + DWI
rad
yielded AUC
T
/AUC
V
of 0.80/0.62 and 0.81/0.75, respectively, for predicting 5‐year DSS. Both signatures yielded better or equal prognostic performance to that of MAX
size
(AUC
T
/AUC
V
: 0.69/0.65) and FIGO (AUC
T
/AUC
V
: 0.77/0.64) and were significant predictors of DSS after adjusting for FIGO (HR
T
/HR
V
for T2
rad
: 4.0/2.5 and T2 + DWI
rad
: 4.8/2.1). Adding T2
rad
and T2 + DWI
rad
to FIGO significantly improved DSS prediction compared to FIGO alone in cohort
(T)
(AUC
T
0.86 and 0.88 vs. 0.77), and FIGO with T2 + DWI
rad
tended to the same in cohort
(V)
(AUC
V
0.75 vs. 0.64,
p
= 0.07). High radiomic score for T2 + DWI
rad
was significantly associated with reduced DSS in both cohorts.
Data Conclusion
Radiomic signatures from T2WI and T2WI with DWI may provide added value for pretreatment risk assessment and for guiding tailored treatment strategies in CC.