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Preoperative prediction of miliary changes in the small bowel mesentery in advanced high-grade serous ovarian cancer using MRI radiomics nomogram

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Abstract

Purpose

To develop and validate an MRI-based radiomics nomogram for the preoperative prediction of miliary changes in the small bowel mesentery (MCSBM) in advanced high-grade serous ovarian cancer (HGSOC).

Materials and methods

One hundred and twenty-eight patients with pathologically proved  advanced HGSOC (training cohort: n = 91; validation cohort: n = 37) were retrospectively included. All patients were initially evaluated as MCSBM-negative by preoperative imaging modalities but were finally confirmed by surgery and histopathology (MCSBM-positive: n = 53; MCSBM-negative: n = 75). Five radiomics signatures were built based on the features from multisequence magnetic resonance images. Independent clinicoradiological factors and radiomics-fusion signature were further integrated to construct a radiomics nomogram. The performance of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves and clinical utility.

Results

Radiomics signatures, ascites, and tumor size were independent predictors of MCSBM. A nomogram integrating radiomics features and clinicoradiological factors demonstrated satisfactory predictive performance with areas under the curves (AUCs) of 0.871 (95% CI 0.801–0.941) and 0.858 (95% CI 0.739–0.976) in the training and validation cohorts, respectively. The net reclassification index (NRI) and integrated discrimination improvement (IDI) revealed that the nomogram had a significantly improved ability compared with the clinical model in the training cohort (NRI = 0.343, p = 0.002; IDI = 0.299, p < 0.001) and validation cohort (NRI = 0.409, p = 0.015; IDI = 0.283, p = 0.001).

Conclusion

Our proposed nomogram has the potential to serve as a noninvasive tool for the prediction of MCSBM, which is helpful for the individualized assessment of advanced HGSOC patients.

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Funding

This study was granted by the project of National Natural Science Foundations of China (Grant No.81901704, No.81971579), Natural Science Foundation of Shanghai (22ZR1412500), Shanghai Health and Family Planning Commission Youth Fund Project (20194Y0489), Shanghai Municipal Commission of Science and Technology (No. 19411972000), and Shanghai “Rising Stars of Medical Talent” Youth Development Program—Medical Imaging Practitioner Program (SHWRS (2020) 087).

Author information

Author notes

  1. Qinhao Guo, Zijing Lin, Xiaohua Wu, Yajia Gu, and Haiming Li have contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China

    Qinhao Guo & Xiaohua Wu

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Qinhao Guo, Zijing Lin, Jing Lu, Rong Li, Xiaohua Wu, Yajia Gu & Haiming Li

  3. Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China

    Zijing Lin, Jing Lu, Rong Li, Yajia Gu & Haiming Li

  4. Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, 201508, China

    Zijing Lin, Lin Deng & Jinwei Qiang

  5. Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Lei Wu

  6. Guangdong Cardiovascular Institute, Guangzhou, 510080, China

    Lei Wu

Authors
  1. Qinhao Guo
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Contributions

QG: Conceptualization, data curation, formal analysis, investigation, project administration, writing—original draft; ZL: Conceptualization, data curation, methodology, visualization, writing—original draft; JL and RL: Data curation, writing-original draft; LW and LD: Methodology, writing—original draft; JQ: Supervision, writing-review & editing; XW: Resources, supervision, writing—review and editing; YG: project administration, resources, supervision, writing-review & editing; HL: Conceptualization, data curation, investigation, project administration, supervision, writing-original graft, writing—review and editing.

Corresponding author

Correspondence to Haiming Li.

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Guo, Q., Lin, Z., Lu, J. et al. Preoperative prediction of miliary changes in the small bowel mesentery in advanced high-grade serous ovarian cancer using MRI radiomics nomogram. Abdom Radiol 48, 1119–1130 (2023). https://doi.org/10.1007/s00261-023-03802-7

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