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• Clinical Article •
The development and external validation of a model based on MRI quantification, pathology, and blood cell parameters to predict the efficacy of concurrent chemoradiotherapy for stage ⅡB-Ⅲ cervical cancer
WANG Yajing  LI Weilan  CHENG Huixin  CUI Liqiang  YU Hong  GUO Yanjuan  XIE Zongyuan 

WANG Y J, LI W L, CHENG H X, et al. The development and external validation of a model based on MRI quantification, pathology, and blood cell parameters to predict the efficacy of concurrent chemoradiotherapy for stage ⅡB-Ⅲ cervical cancer[J]. Chin J Magn Reson Imaging, 2023, 14(8): 86-93. DOI:10.12015/issn.1674-8034.2023.08.014.


[Abstract] Objective To develop and test a model for predicting the efficacy of concurrent chemoradiotherapy for stage ⅡB-Ⅲ cervical cancer based on quantitative MRI, pathology, and blood cell parameters.Materials and Methods From March 2020 to June 2022, clinical data from 151 cervical cancer patients at the North China University of Science and Technology Affiliated Hospital were analyzed retrospectively, and data from 93 cervical cancer patients at the Hebei General Hospital for Veterans were used for model external validation. To screen for risk factors associated with the efficacy of concurrent chemoradiotherapy, least absolute shrinkage and selection operator (LASSO) regression was used. The value of a risk factor model for the efficacy of concurrent chemoradiotherapy was evaluated using the consistency index (C-index), calibration curve, mean absolute error (MAE), and decision curve analysis (DCA).Results LASSO regression analysis revealed that elevated volume transport constant (Ktrans), apparent dispersion coefficient (ADC), and perfusion-related volume fraction (f) were independent factors for objective remission (OR) following concurrent chemoradiotherapy. High International Federation of Gynecology and Obstetrics (FIGO) staging, lymph node metastasis, elevated extravascular extracellular volume ratio (Ve), elevated slow ADC (D), and elevated monocyte to lymphocyte ratio (MLR) were all independent risk factors for OR after concurrent chemoradiotherapy. The C-index and MAE of model F (which included FIGO staging, lymph node metastasis, Ktrans, Ve, ADC, D, f, and MLR) were 0.984 and 0.033, respectively, which were higher than those of model S (which included Ktrans, Ve, ADC, D, and f; 0.940, 0.020) and model T (which included FIGO staging, lymph node metastasis, and MLR; 0.897, 0.020). The calibration curves showed that the calibration curve for model S overlapped with the ideal curve slightly better than the calibration curves for models F and T. Over the entire risk threshold range, the DCA showed that model F had a higher net benefit than model S and model T. Model F had a higher C-index (0.996) than model S (0.942) and model T (0.917) and a lower MAE (0.017) than model S (0.043) and model T (0.043), according to the model validation results. The calibration curves showed that the calibration curves for model F and model S overlapped with the ideal curve more closely than model T. Over the entire risk threshold range, the DCA showed that model F had a higher net benefit than model S and model T.Conclusions FIGO staging, lymph node metastasis, Ktrans, Ve, ADC, D, f, and MLR are associated with the efficacy of concurrent chemoradiotherapy for stage ⅡB-Ⅲ cervical cancer. The model based on the above indicators can aid in predicting the efficacy of concurrent chemoradiotherapy, and its efficacy is higher than that of the MRI-only quantitative parameter model and the pathology and blood cell parameter model.
[Keywords] cervical cancer；concurrent chemoradiotherapy；magnetic resonance imaging；model；pathology；blood cells；efficacy prediction；external validation

WANG Yajing1   LI Weilan1   CHENG Huixin2   CUI Liqiang2   YU Hong3   GUO Yanjuan4   XIE Zongyuan1*  

1 Department of MRI, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China

2 Department of CT/MRI, Hebei General Hospital for Veterans, Xingtai 054000, China

3 Department of MRI, Tangshan Caofeidian District Hospital, Tangshan 063200, China

4 Department of Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China

Corresponding author: Xie ZY, E-mail: xied126@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Medical Science Research Project of the Health Commission of Hebei Province (No. 20201245, 20231255).
Received  2023-03-02
Accepted  2023-07-21
DOI: 10.12015/issn.1674-8034.2023.08.014
WANG Y J, LI W L, CHENG H X, et al. The development and external validation of a model based on MRI quantification, pathology, and blood cell parameters to predict the efficacy of concurrent chemoradiotherapy for stage ⅡB-Ⅲ cervical cancer[J]. Chin J Magn Reson Imaging, 2023, 14(8): 86-93. DOI:10.12015/issn.1674-8034.2023.08.014.

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