目的:基于磁共振成像(MRI)的影像组学方法和深度学习方法在宫颈腺癌(AC)中的作用尚未探讨。在这里,我们旨在基于MRI影像组学和临床特征为AC患者建立预后预测模型.
方法:收集并分析了一百九十七例宫颈AC患者的临床和病理资料。对于每个病人来说,从T2加权MRI图像中提取107个影像组学特征。使用Spearman相关和随机森林(RF)算法进行特征选择,并利用支持向量机(SVM)技术建立预测模型。深度学习模型还通过卷积神经网络(CNN)使用T2加权MRI图像和临床病理特征进行了训练。Kaplan-Meier曲线使用显著特征进行分析。此外,来自另一组56例AC患者的信息被用于独立验证.
结果:共107个影像组学特征和6个临床病理特征(年龄,FIGO阶段,分化,侵入深度,淋巴管间隙侵犯(LVSI),和淋巴结转移(LNM)包括在分析中。在预测三年时,4年,和5年DFS,仅针对影像组学特征进行训练的模型的AUC值为0.659(95CI:0.620-0.716),0.791(95CI:0.603-0.922),和0.853(95CI:0.745-0.912),分别。然而,组合模型,结合影像组学和临床病理特征,AUC值为0.934(95CI:0.885-0.981),优于影像组学模型,0.937(95CI:0.867-0.995),和0.916(95CI:0.857-0.970),分别。对于深度学习模型,基于MRI的模型在3年DFS中获得了0.857、0.777和0.828的AUC,4年DFS和5年DFS预测,分别。组合的深度学习模型获得了改进的性能,AUC为0.903。0.862和0.969。在独立测试集中,组合模型在3年DFS下的AUC为0.873、0.858和0.914,4年DFS和5年DFS预测,分别。
结论:我们证明了基于MRI的影像组学与宫颈腺癌临床病理特征整合的预后价值。当与临床数据相结合时,影像组学和深度学习模型都显示出改进的预测性能。强调多模式方法在患者管理中的重要性。
OBJECTIVE: The roles of magnetic resonance imaging (MRI) -based radiomics approach and deep learning approach in cervical adenocarcinoma (AC) have not been explored. Herein, we aim to develop prognosis-predictive models based on MRI-radiomics and clinical features for AC patients.
METHODS: Clinical and pathological information from one hundred and ninety-seven patients with cervical AC was collected and analyzed. For each patient, 107 radiomics features were extracted from T2-weighted MRI images. Feature selection was performed using Spearman correlation and random forest (RF) algorithms, and predictive models were built using support vector machine (SVM) technique. Deep learning models were also trained with T2-weighted MRI images and clinicopathological features through Convolutional Neural Network (CNN). Kaplan-Meier curve was analyzed using significant features. In addition, information from another group of 56 AC patients was used for the independent validation.
RESULTS: A total of 107 radiomics features and 6 clinicopathological features (age, FIGO stage, differentiation, invasion depth, lymphovascular space invasion (LVSI), and lymph node metastasis (LNM) were included in the analysis. When predicting the 3-year, 4-year, and 5-year DFS, the model trained solely on radiomics features achieved AUC values of 0.659 (95%CI: 0.620-0.716), 0.791 (95%CI: 0.603-0.922), and 0.853 (95%CI: 0.745-0.912), respectively. However, the combined model, incorporating both radiomics and clinicopathological features, outperformed the radiomics model with AUC values of 0.934 (95%CI: 0.885-0.981), 0.937 (95%CI: 0.867-0.995), and 0.916 (95%CI: 0.857-0.970), respectively. For deep learning models, the MRI-based models achieved an AUC of 0.857, 0.777 and 0.828 for 3-year DFS, 4-year DFS and 5-year DFS prediction, respectively. And the combined deep learning models got a improved performance, the AUCs were 0.903. 0.862 and 0.969. In the independent test set, the combined model achieved an AUC of 0.873, 0.858 and 0.914 for 3-year DFS, 4-year DFS and 5-year DFS prediction, respectively.
CONCLUSIONS: We demonstrated the prognostic value of integrating MRI-based radiomics and clinicopathological features in cervical adenocarcinoma. Both radiomics and deep learning models showed improved predictive performance when combined with clinical data, emphasizing the importance of a multimodal approach in patient management.