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Multiparametric MRI-based radiomics nomogram for identifying cervix-corpus junction cervical adenocarcinoma from endometrioid adenocarcinoma

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Abstract

Objective

To developed a magnetic resonance imaging (MRI) radiomics nomogram to identify adenocarcinoma at the cervix-corpus junction originating from the endometrium or cervix in order to better guide clinical treatment.

Methods

Between February 2011 and September 2021, the clinicopathological data and MRI in 143 patients with histopathologically confirmed cervical adenocarcinoma (CAC, n = 86) and endometrioid adenocarcinoma (EAC, n = 57) were retrospectively analyzed at the cervix-corpus junction. Radiomics features were extracted from fat-suppressed T2-weighted imaging (FS-T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) maps, and delayed phase contrast-enhanced T1-weighted imaging (CE-T1WI) sequences. A radiomics nomogram was developed integrating radscore with independent clinical risk factors. The area under the curve (AUC) was used to evaluate the diagnostic efficacy of the radscore, nomogram and two different experienced radiologists in differentiating CAC from EAC at the cervix-corpus junction, and Delong test was applied to compare the differences of their diagnostic performance.

Results

In the training cohort, the AUC was 0.93 for radscore; 0.97 for radiomics nomograms; 0.85 and 0.86 for radiologists 1 and 2, respectively. Delong test showed that the differential efficacy of nomogram was significant better than those of radiologists in the training cohort (both P < 0.05).

Conclusions

The nomogram based on radscore and clinical risk factors could better differentiate CAC from EAC at the cervix-corpus junction than radiologists, and preoperatively and non-invasively identify the origin of adenocarcinoma at the cervix-corpus junction, which facilitates clinicians to make individualized treatment decision.

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Funding

This work was supported by the Shanghai Municipal Health Commission (No. 2020YJZK0209); the National Natural Science Foundation of China (No. 81971579); and the Youth Start-up Fund of Jinshan Hospital of Fudan University (JYQN-JC-202004).

Author information

Author notes

  1. Yuhan Fang, Keying Wang, and Meiling Xiao have equally contributed to this work.

  2. Jinwei Qiang and Ying Li have equally contributed to this work.

Authors and Affiliations

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

    Yuhan Fang, Keying Wang, Zijing Lin, Jinwei Qiang & Ying Li

  2. Department of Radiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 201204, China

    Yuhan Fang & Jiejun Cheng

  3. Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China

    Meiling Xiao

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  1. Yuhan Fang
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Correspondence to Jinwei Qiang.

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Appendix

Appendix

See Table 

Table 4 MRI sequences and parameters for CAC and EAC patients in a 1.5 T MRI system
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Fang, Y., Wang, K., Xiao, M. et al. Multiparametric MRI-based radiomics nomogram for identifying cervix-corpus junction cervical adenocarcinoma from endometrioid adenocarcinoma. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04214-x

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