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The radiomics model based on APT for preoperative prediction of cervical cancer lymphovascular space invasion
AN Qi  ZHANG Qinhe  ZHONG Lin  MA Changjun  ZHANG Hanyue  LI Jun  WANG Siqi  LIN Liangjie  TIAN Shifeng  LIU Ailian 

Cite this article as: AN Q, ZHANG Q H, ZHONG L, et al. The radiomics model based on APT for preoperative prediction of cervical cancer lymphovascular space invasion[J]. Chin J Magn Reson Imaging, 2024, 15(8): 31-38. DOI:10.12015/issn.1674-8034.2024.08.005.


[Abstract] Objective To explore the value of amide proton transfer weighted imaging (APTw) radiomics in the preoperative assessment of lymphovascular space invasion (LVSI) in cervical cancer.Materials and Methods Retrospective analysis of 66 cases of pathologically confirmed cervical cancer and their imaging data. All patients underwent pelvic 3.0 T MRI examination, including axial T2WI, sagittal T2WI, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and 3D-APTw sequence scanning. Region of interest (ROI) within the tumor parenchyma were delineated on the APTw-T2WI fusion images, and APT values were recorded. Tumor lesions were segmented on the reconstructed APTw images, and radiomics features were extracted. Intra-class correlation coefficient (ICC) was employed to select radiomics features with good test-retest reliability both intra- and inter-observer assessments (ICC>0.900). Recursive feature elimination (RFE) and least absolute shrinkage and selection operator (LASSO) algorithms were employed for feature dimensionality reduction and selection. A clinical model, APTw radiomics model and combined model were constructed based on logistic regression classifier. The diagnostic performance and clinical utility of the models were evaluated using receiver operating characteristic (ROC) curves and decision curve analysis (DCA). The predictive performance of different models was compared using the DeLong test.Results In the training set, the APTw radiomics model demonstrated higher efficacy in predicting cervical cancer LVSI compared to the clinical model (AUC=0.826 vs. 0.675), with statistically significant differences (DeLong test P<0.05). In the training set and the test set, the AUC values of the combined model were 0.838 and 0.825, respectively. DeLong test results showed that the combined model significantly outperformed the clinical model and APTw radiomics model in preoperative assessment of LVSI in the training set (all P<0.05). The decision curve demonstrated that the APTw radiomics model and the combined model exhibit higher clinical utility in both the train and test sets.Conclusions The radiomics model based on the APTw shows great potential in preoperatively predicting the LVSI status of patients with cervical cancer. Integration with clinical factors further enhances predictive performance, holding prospects to provide crucial support for individualized treatment and prognosis assessment of cervical cancer patients.
[Keywords] cervical cancer；lymphovascular space invasion；radiomics；magnetic resonance imaging；amide proton transfer weighted imaging；preoperative prediction

AN Qi1   ZHANG Qinhe1   ZHONG Lin2   MA Changjun3   ZHANG Hanyue1   LI Jun1   WANG Siqi1   LIN Liangjie4   TIAN Shifeng1   LIU Ailian1*  

1 Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

2 Department of Pathology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

3 Medical Department of Dalian University of Technology, Dalian 116011, China

4 Beijing Branch, Philips (China) Investment Co, Ltd. Beijing 100016, China

Corresponding author: LIU A L, E-mail: cjr.liuailian@vip.163.com

Conflicts of interest   None.

Received  2024-04-24
Accepted  2024-07-12
DOI: 10.12015/issn.1674-8034.2024.08.005
Cite this article as: AN Q, ZHANG Q H, ZHONG L, et al. The radiomics model based on APT for preoperative prediction of cervical cancer lymphovascular space invasion[J]. Chin J Magn Reson Imaging, 2024, 15(8): 31-38. DOI:10.12015/issn.1674-8034.2024.08.005.

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