A nomogram-based optimized Radscore for preoperative prediction of lymph node metastasis in patients with cervical cancer after neoadjuvant chemotherapy

Frontiers in Oncology

Oncology

Wei Ding¹  Lei Zhang²  Hongyan Hu³  Lan Zhang⁵  Zhenhui Li⁶  Suixing Zhong⁶  Miaomiao Li⁶  Huimei Zhang⁶  Conghui Ai⁶ 

[1] 920th Hospital of Joint Logistics Support Force, Kunming, Yunnan, China;Department of Gynecology, Yunnan Tumor Hospital & The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China;Department of Pathology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Center), Kunming, China;Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Kunming, China;Department of Radiology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China;Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China;

关键词: cervical cancer;    neoadjuvant chemotherapy;    multi-parameter MRI;    lymph node metastasis;    radiomics;   

DOI  :  10.3389/fonc.2023.1117339

 received in 2022-12-06, accepted in 2023-07-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeTo construct a superior single-sequence radiomics signature to assess lymphatic metastasis in patients with cervical cancer after neoadjuvant chemotherapy (NACT).MethodsThe first half of the study was retrospectively conducted in our hospital between October 2012 and December 2021. Based on the history of NACT before surgery, all pathologies were divided into the NACT and surgery groups. The incidence rate of lymphatic metastasis in the two groups was determined based on the results of pathological examination following lymphadenectomy. Patients from the primary and secondary centers who received NACT were enrolled for radiomics analysis in the second half of the study. The patient cohorts from the primary center were randomly divided into training and test cohorts at a ratio of 7:3. All patients underwent magnetic resonance imaging after NACT. Segmentation was performed on T1-weighted imaging (T1WI), T2-weighted imaging, contrast-enhanced T1WI (CET1WI), and diffusion-weighted imaging.ResultsThe rate of lymphatic metastasis in the NACT group (33.2%) was significantly lower than that in the surgery group (58.7%, P=0.007). The area under the receiver operating characteristic curve values of Radscore_CET1WI for predicting lymph node metastasis and non-lymphatic metastasis were 0.800 and 0.797 in the training and test cohorts, respectively, exhibiting superior diagnostic performance. After combining the clinical variables, the tumor diameter on magnetic resonance imaging was incorporated into the Rad_clin model constructed using Radscore_CET1WI. The Hosmer–Lemeshow test of the Rad_clin model revealed no significant differences in the goodness of fit in the training (P=0.594) or test cohort (P=0.748).ConclusionsThe Radscore provided by CET1WI may achieve a higher diagnostic performance in predicting lymph node metastasis. Superior performance was observed with the Rad_clin model.

【 授权许可】

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Copyright © 2023 Ai, Zhang, Ding, Zhong, Li, Li, Zhang, Zhang, Zhang and Hu