Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (6): 45-54.doi: 10.6040/j.issn.1671-7554.0.2024.0958

• Clinical Medicine • Previous Articles    

Predictive value of intratumoral and peritumoral DCE-MRI imaging histology for progression-free survival in patients with cervical cancer

WANG Lei1, CHANG Xiao1, WANG Zimeng1, LI Jiaojiao2, CUI Shujun2, YANG Fei2, ZHU Yuexiang2   

  1. 1. Graduate School, Hebei North University, Zhangjiakou 075000, Hebei, China;
    2. Department of Medical Imaging, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei, China
  • Published:2025-07-08

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Abstract: Objective To explore the predictive value of intratumoral and peritumoral radiomics in different ranges for progression-free survival(PFS)in patients with locally advanced cervical cancer undergoing concurrent chemotherapy(CCRT). Methods A total of 135 patients with cervical cancer were retrospectively selected, including 32 patients with progression and 103 patients without progression. They were divided into the training set and the validation set in a 7∶ 3 ratio. On the basis of the second phase images of dynanic contrast-enhanced magnetic resonance imaging(DCE-MRI), three-dimensional volume of interest(VOI)delimitations were performed in the 3, 5, and 7 mm areas within and around the tumor. Radiomics features were extracted and dimensionally reduced, respectively. The selected characteristics were used to construct combined intratumoral, peritumoral, and intratumoral-peritumoral radiomic models to compare predictive efficacy. Clinical models were constructed by retaining statistically significant clinical characteristics. A comprehensive model was jointly established based on the best radiomic features of area under curve(AUC)and the screened clinical features. The predictive ability of the model was evaluated using AUC and the consistency index(C-index). The models with the highest AUC and C-index values were used to evaluate the calibration curve, decision curve analysis(DCA)and Kaplan-Meier survival curve. Results The intratumoral + 5 mm peritumoral model showed better predictive efficacy than other radiomic models, with an AUC of 0.852, Compared to the clinical and radiomic models, the comprehensive model showed the best predictive efficacy, with AUCs of 0.766, 0.852, and 0.872, respectively. Through the calibration curve and DCA analysis, the comprehensive model had a high degree of calibration and a large clinical net benefit. The Kaplan-Meier survival curve could distinguish between high-risk patients and low-risk patients with disease progression. Conclusion The combined intratumoral and peritumoral radiomic characteristics based on DCE-MRI can be used as an effective indicator for evaluating PFS in patients with locally advanced cervical cancer undergoing CCRT. Among them, the intratumoral + 5 mm peritumoral model shows higher predictive ability, and the comprehensive model incorporating clinical parameters has better efficacy.

Key words: Cervical cancer, Nuclear magnetic resonance, Imaging omics, Peritumor microenvironment, Survival prognosis

CLC Number: 

  • R737.33
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