基于矢状位T2WI瘤内瘤周影像组学列线图术前预测ⅠB期和ⅡA期宫颈癌的研究OA北大核心CSTPCD

Objective:A comprehensive nomogram based on radiomics signature and clinical risk factors in the intra-and peritumoral regions of T2 weighted imaging (T2WI) was developed for the prediction of ⅠB and ⅡA stage in cervical cancer. Materials and Methods:A total of 120 patients with stage ⅠB and ⅡA cervical cancer,who underwent preoperative MRI and radical hysterectomy with systematic pelvic lymph node dissection,were analysed retrospectively from two hospitals,and then randomly divided into training (n=80) and external validation groups (n=40). Intra-and peritumoral features (0−6 mm) were extracted separately in T2WI and selected by the Pearson analysis and the least absolute shrinkage and selection operator (LASSO) regression. Radiomic models were built using the best selected features from different regions. Receiver operating characteristic (ROC) was drew and the prediction performance of multi-regional radiomic models was built. Finally,the optimal peritumoral region was selected and the nomogram was developed combining the optimal peritumoral radiomics signature and the most predictive clinical parameters. The calibration degree of the model was evaluated by calibration curve and the application value of the model was evaluated by decision curve analysis (DCA). Results:Six effective radiomics features,selected from the peritumoral regions with 3 mm distances in the T2WI,had the best predictive performance,achieving an area under curve (AUC) of 0.972 and 0.857 in the training and validation groups,respectively. The prediction efficiency of the model based on the maximum diameter and red blood cell (RBC),which were the clinical independent risk factors,is next,achieving an AUC of 0.940 and 0.847 in the training and validation groups,respectively. The prediction efficiency of the nomogram based on the maximum diameter,red RBC and six effective radiomics features from the peritumoral regions with 3 mm distances was more stable,achieving an AUC of 0.952 and 0.939 in the training and validation groups,respectively. The nomogram,tested by calibration curve and DCA,had the higher calibration and greater net clinical benefit. Conclusions:The nomogram that was developed by intra-and peritumoral regions with 3 mm distances radiomics was excellent for the preoperative prediction of ⅠB and ⅡA stage in cervical cancer. It is important clinical significance to guide the individual treatment of patients.