Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1472892
This article is part of the Research Topic Diagnosis and Treatment of Vulvar Cancer View all 3 articles

Preoperative prediction of lymph node metastasis in endometrial cancer patients via an intratumoral and peritumoral multiparameter MRI radiomics nomogram

Provisionally accepted
Bin Yan Bin Yan 1*Tingting Zhao Tingting Zhao 2Ying Deng Ying Deng 1Yili Zhang Yili Zhang 3*
  • 1 Department of Radiology, Shaanxi Provincial Tumor Hospital, Xi'an, China
  • 2 Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, Shaanxi, China
  • 3 Department of Medical Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China

The final, formatted version of the article will be published soon.

    Introduction: While lymph node metastasis (LNM) plays a critical role in determining treatment options for endometrial cancer (EC) patients, the existing preoperative methods for evaluating the lymph node state are not always satisfactory. This study aimed to develop and validate a nomogram based on intra- and peritumoral radiomics features and multiparameter magnetic resonance imaging (MRI) features to preoperatively predict LNM in EC patients. Methods: Three hundred and seventy-four women with histologically confirmed EC were divided into training (n = 220), test (n = 94), and independent validation (n = 60) cohorts. Radiomic features were extracted from intra- and peritumoral regions via axial T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) mapping. A radiomics model (annotated as the Radscore) was established using the selected features from different regions. The clinical parameters were statistically analyzed. A nomogram was developed by combining the Radscore and the most predictive clinical parameters. Decision curve analysis (DCA) and the net reclassification index (NRI) were used to assess the clinical benefit of using the nomogram. Results: Nine radiomics features were ultimately selected from the intra- and peritumoral regions via ADC mapping and T2WI. The nomogram combining the Radscore, serum CA125 level, and tumor area ratio achieved the highest AUCs in the training, test and independent validation sets (nomogram vs. Radscore vs. clinical model: 0.878 vs. 0.850 vs. 0.674 (training), 0.877 vs. 0.838 vs. 0.668 (test), and 0.864 vs. 0.836 vs. 0.618 (independent validation)). The DCA and NRI results revealed the nomogram had greater diagnostic performance and net clinical benefits than the Radscore alone. Conclusion: The combined intra- and peritumoral region multiparameter MRI radiomics nomogram showed good diagnostic performance and could be used to preoperatively predict LNM in patients with EC.

    Keywords: endometrial cancer, Lymphatic Metastasis, Lymph Node, Magnetic Resonance Imaging, Radiomics

    Received: 30 Jul 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Yan, Zhao, Deng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Bin Yan, Department of Radiology, Shaanxi Provincial Tumor Hospital, Xi'an, China
    Yili Zhang, Department of Medical Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.