Magnetic resonance imaging features of tumor and lymph node to predict clinical outcome in node-positive cervical cancer: a retrospective analysis

Park, Shin Hyung; Hahm, Myong Hun; Bae, Bong Kyung; Chong, Gun Oh; Jeong, Shin Young; Na, Sungdae; Jeong, Sungmoon; Kim, Jae-Chul

doi:10.1186/s13014-020-01502-w

Cited by 25 publications

(19 citation statements)

References 33 publications

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“…Radiomics has been involved in many aspects of cervical cancer, including prediction of tumor staging (21,22), histological grading (23,24), lymphovascular space invasion (LVI) (25), LNM (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), treatment response (37)(38)(39)(40)(41)(42), and outcome (43)(44)(45)(46)(47)(48) based on multimodal imaging tools (e.g., CT, MRI, and PET/CT). In clinical practice, the issues of most concern may be the evaluation of LNM, treatment response, and survival prediction.…”

Section: Discussionmentioning

confidence: 99%

Radiomic Score as a Potential Imaging Biomarker for Predicting Survival in Patients With Cervical Cancer

Zhu

Jian

et al. 2021

Front. Oncol.

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ObjectivesAccurate prediction of prognosis will help adjust or optimize the treatment of cervical cancer and benefit the patients. We aimed to investigate the incremental value of radiomics when added to the FIGO stage in predicting overall survival (OS) in patients with cervical cancer.MethodsThis retrospective study included 106 patients with cervical cancer (FIGO stage IB1–IVa) between October 2017 and May 2019. Patients were randomly divided into a training cohort (n = 74) and validation cohort (n = 32). All patients underwent contrast-enhanced computed tomography (CT) prior to treatment. The ITK-SNAP software was used to delineate the region of interest on pre-treatment standard-of-care CT scans. We extracted 792 two-dimensional radiomic features by the Analysis Kit (AK) software. Pearson correlation coefficient analysis and Relief were used to detect the most discriminatory features. The radiomic signature (i.e., Radscore) was constructed via Adaboost with Leave-one-out cross-validation. Prognostic models were built by Cox regression model using Akaike information criterion (AIC) as the stopping rule. A nomogram was established to individually predict the OS of patients. Patients were then stratified into high- and low-risk groups according to the Youden index. Kaplan–Meier curves were used to compare the survival difference between the high- and low-risk groups.ResultsSix textural features were identified, including one gray-level co-occurrence matrix feature and five gray-level run-length matrix features. Only the FIGO stage and Radscore were independent risk factors associated with OS (p < 0.05). The C-index of the FIGO stage in the training and validation cohorts was 0.703 (95% CI: 0.572–0.834) and 0.700 (95% CI: 0.526–0.874), respectively. Correspondingly, the C-index of Radscore was 0.794 (95% CI: 0.707–0.880) and 0.754 (95% CI: 0.623–0.885). The incorporation of the FIGO stage and Radscore achieved better performance, with a C-index of 0.830 (95% CI: 0.738–0.922) and 0.772 (95% CI: 0.615–0.929), respectively. The nomogram based on the FIGO stage and Radscore could individually predict the OS probability with good discrimination and calibration. The high-risk patients had shorter OS compared with the low-risk patients (p < 0.05).ConclusionRadiomics has the potential for noninvasive risk stratification and may improve the prediction of OS in patients with cervical cancer when added to the FIGO stage.

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Section: Discussionmentioning

confidence: 99%

Radiomic Score as a Potential Imaging Biomarker for Predicting Survival in Patients With Cervical Cancer

Zhu

Jian

et al. 2021

Front. Oncol.

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“…Only N+ patients were considered for the analysis since it has been shown in previous studies related to head and neck cancer that the addition of radiomic features from the lymphnodal ROI provides a better prognostic ability than radiomics from the main tumor alone [ 17 , 35 ]. Metastatic lymph node involvement was defined according to Ho et al [ 36 ]: criteria included, namely, central necrosis, extra capsular spread, shortest diameter of cervical or medial retropharyngeal lymph nodes >1 cm and >5 mm for lateral retropharyngeal lymph node(s).…”

Section: Methodsmentioning

confidence: 99%

Baseline MRI-Radiomics Can Predict Overall Survival in Non-Endemic EBV-Related Nasopharyngeal Carcinoma Patients

Bologna

Corino

Calareso

et al. 2020

Cancers

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Advanced stage nasopharyngeal cancer (NPC) shows highly variable treatment outcomes, suggesting the need for independent prognostic factors. This study aims at developing a magnetic resonance imaging (MRI)-based radiomic signature as a prognostic marker for different clinical endpoints in NPC patients from non-endemic areas. A total 136 patients with advanced NPC and available MRI imaging (T1-weighted and T2-weighted) were selected. For each patient, 2144 radiomic features were extracted from the main tumor and largest lymph node. A multivariate Cox regression model was trained on a subset of features to obtain a radiomic signature for overall survival (OS), which was also applied for the prognosis of other clinical endpoints. Validation was performed using 10-fold cross-validation. The added prognostic value of the radiomic features to clinical features and volume was also evaluated. The radiomics-based signature had good prognostic power for OS and loco-regional recurrence-free survival (LRFS), with C-index of 0.68 and 0.72, respectively. In all the cases, the addition of radiomics to clinical features improved the prognostic performance. Radiomic features can provide independent prognostic information in NPC patients from non-endemic areas.

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“…They usually reveal low to intermediate T1- and high T2-weighted signal intensities, or occasionally high T1- and T2-weighted signal intensities with heterogeneous enhancement on enhanced T1WI [ 38 ]. On DWI, recurrence or metastases present strong contrast with the dark background signal from fat deposited around, based on metabolic or physiological changes [ 39 , 40 ]. Additionally, one should note that the clear volumetric information provided by MRI may be meaningful for determining the treatment dose [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Head-to-Head Comparison of Neck 18F-FDG PET/MR and PET/CT in the Diagnosis of Differentiated Thyroid Carcinoma Patients after Comprehensive Treatment

Song

Liu

Ruan

et al. 2021

Cancers

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We explored the clinical value of 18F-FDG PET/MR in a head-to-head comparison with PET/CT in loco-regional recurrent and metastatic cervical lymph nodes of differentiated thyroid carcinoma (DTC) patients after comprehensive treatment. 18F-FDG PET/CT and neck PET/MR scans that were performed in DTC patients with suspected recurrence or cervical lymph node metastasis after comprehensive treatment were retrospectively analyzed. Detection rates, diagnostic efficacy, image conspicuity, and measured parameters were compared between 18F-FDG PET/CT and PET/MR. The gold standard was histopathological diagnosis or clinical and imaging follow-up results for more than 6 months. Among the 37 patients enrolled, no suspicious signs of tumor were found in 10 patients, 24 patients had lymph node metastasis, and 3 patients had both recurrence and lymph node metastases. A total of 130 lesions were analyzed, including 3 malignant and 6 benign thyroid nodules, as well as 74 malignant and 47 benign cervical lymph nodes. Compared with PET/CT, PET/MR presented better detection rates (91.5% vs. 80.8%), image conspicuity (2.74 ± 0.60 vs. 1.9 ± 0.50, p < 0.001, especially in complex level II), and sensitivity (80.5% vs. 61.0%). SUVmax differed in benign and malignant lymph nodes in both imaging modalities (p < 0.05). For the same lesion, the SUVmax, SUVmean, and diameters measured by PET/MR and PET/CT were consistent and had significant correlation. In conclusion, compared with 18F-FDG PET/CT, PET/MR was more accurate in determining recurrent and metastatic lesions, both from a patient-based and from a lesion-based perspective. Adding local PET/MR after whole-body PET/CT may be recommended to provide more precise diagnostic information and scope of surgical resection without additional ionizing radiation. Further scaling-up prospective studies and economic benefit analysis are expected.

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Magnetic resonance imaging features of tumor and lymph node to predict clinical outcome in node-positive cervical cancer: a retrospective analysis

Cited by 25 publications

References 33 publications

Radiomic Score as a Potential Imaging Biomarker for Predicting Survival in Patients With Cervical Cancer

Radiomic Score as a Potential Imaging Biomarker for Predicting Survival in Patients With Cervical Cancer

Baseline MRI-Radiomics Can Predict Overall Survival in Non-Endemic EBV-Related Nasopharyngeal Carcinoma Patients

Head-to-Head Comparison of Neck 18F-FDG PET/MR and PET/CT in the Diagnosis of Differentiated Thyroid Carcinoma Patients after Comprehensive Treatment

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