Habitat Radiomics Outperforms Whole-Placenta Analysis for Predicting Placenta Accreta Spectrum Disorders on T2WI: A Multicenter Study

Habitat Radiomics Outperforms Whole-Placenta Analysis for Predicting Placenta Accreta Spectrum Disorders on T2WI: A Multicenter Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Habitat Radiomics Outperforms Whole-Placenta Analysis for Predicting Placenta Accreta Spectrum Disorders on T2WI: A Multicenter Study changyi Guo, xirong zhang, Ruiyu huang, Xinyang zhu, nan yu, dong han, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7769855/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Current MRI diagnosis of Placenta Accreta Spectrum is limited by subjective interpretation and whole-placenta radiomics that miss key local features. This multicenter study tests whether radiomics targeting the specific placental invasion site ("placental habitat") on T2WI outperforms both whole-placenta analysis and expert assessment. Materials and Methods This multicenter retrospective study enrolled three cohorts for model training, internal validation, and independent external testing. A total of 597 pregnant women with suspected placenta accreta spectrum disorders were included, with Center A contributing 481 cases, Center B providing 68 cases, and Center C contributing 48 cases. Among these, 10 cases from Center A and all cases from Center C were combined to form an independent external test set. The remaining 539 cases from Centers A and B constituted the development cohort, which was randomly divided in a stratified manner into a training set of 377 cases and a validation set of 162 cases. Radiomics features were extracted from two regions: (1) whole-placenta regions and (2) habitat-defined subregions (identified via K-means clustering on T2WI). Four predictive models were developed: a clinical model (incorporating clinical risk factors), a Radiomics model (using whole-placenta features), a habitat model (utilizing habitat-specific features), and a combined model (integrating clinical and habitat features). Performance was benchmarked against assessments by junior and senior radiologists. Model evaluation was conducted using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) as the primary metric. Results In the training cohort, the AUC values were as follows: junior radiologists (0.601), senior radiologists (0.620), the clinical model (0.841), the Radiomics model (0.777), the habitat model (0.885), and the combined model (0.896). In the validation cohort, the corresponding AUC values were: junior radiologists (0.532), senior radiologists (0.551), the clinical model (0.819), the Radiomics model (0.717), the habitat model (0.862), and the combined model (0.876). In the external test cohort, the AUC values were: junior radiologists (0.570), senior radiologists (0.625), the clinical model (0.814), the Radiomics model (0.751), the habitat model (0.812), and the combined model (0.823). Conclusion Habitat Radiomics consistently outperformed both whole-placenta analysis and radiologist assessment across all cohorts. The habitat model achieved the highest standalone performance (AUC: 0.862–0.885), demonstrating superior robustness and generalizability for PAS prediction. Integration of clinical features further enhanced performance (combined model AUC: 0.823–0.896). Placenta accreta spectrum disorders Habitat Radiomics Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7769855","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":542116206,"identity":"436a0952-a45e-4c36-80d3-a045f620e6f1","order_by":0,"name":"changyi Guo","email":"","orcid":"","institution":"The Second Affiliated Hospital of Shaanxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"changyi","middleName":"","lastName":"Guo","suffix":""},{"id":542116207,"identity":"b6c40ac5-1b1b-4777-96c3-b8119f3df620","order_by":1,"name":"xirong zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYBACNmb2Awc+8NTI8bM3EKmFj50n8eAMmWPGkj0HiNQix89gfJjHhjlxw40Eoh3GkHCAJ4eNccPNxxtvMNTYRBOhhfHAAYkzMsySt9OKLRiOpeU2EGWLYQ8bG9/tHDMJxobDRGkxOJD4j5mH4eYZUrQc4GGWELjBQ7QWnoSDDTzHDCR7gH5JIMYv8v3HD3/+w1NT389+eOONDzU2hLUgAwOJBFKUQ7SQqmMUjIJRMApGBgAASXw9RIsxM1cAAAAASUVORK5CYII=","orcid":"","institution":"Shaanxi University of Chinese Medicine","correspondingAuthor":true,"prefix":"","firstName":"xirong","middleName":"","lastName":"zhang","suffix":""},{"id":542116208,"identity":"2f0279a4-f52d-45a3-9490-46c54eacc0af","order_by":2,"name":"Ruiyu huang","email":"","orcid":"","institution":"The Second Affiliated Hospital of Shaanxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ruiyu","middleName":"","lastName":"huang","suffix":""},{"id":542116209,"identity":"3f4efb98-f36e-4782-9843-9319b747a69c","order_by":3,"name":"Xinyang zhu","email":"","orcid":"","institution":"The Second Affiliated Hospital of Shaanxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Xinyang","middleName":"","lastName":"zhu","suffix":""},{"id":542116210,"identity":"03d965bc-7a5b-445d-b2d9-7462aebeb505","order_by":4,"name":"nan yu","email":"","orcid":"","institution":"Shaanxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"nan","middleName":"","lastName":"yu","suffix":""},{"id":542116211,"identity":"179d6619-17ec-4c7a-afaa-49c5a9451857","order_by":5,"name":"dong han","email":"","orcid":"","institution":"Affiliated Hospital of Shaanxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"dong","middleName":"","lastName":"han","suffix":""},{"id":542116212,"identity":"c8ff57dc-7665-4632-ab87-cfb842476303","order_by":6,"name":"xiaoqi huang","email":"","orcid":"","institution":"Yanan University Affiliated Hospital","correspondingAuthor":false,"prefix":"","firstName":"xiaoqi","middleName":"","lastName":"huang","suffix":""},{"id":542116213,"identity":"55af4895-9508-42ad-99ad-796b4549dffc","order_by":7,"name":"yiming li","email":"","orcid":"","institution":"Shangqiu First People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"yiming","middleName":"","lastName":"li","suffix":""}],"badges":[],"createdAt":"2025-10-03 03:08:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7769855/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7769855/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95520604,"identity":"8389ca60-6325-4e21-ad01-5c700e71a9fe","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1333171,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/88ac89b2c81c4d1ff31016d2.docx"},{"id":95529102,"identity":"5435a1ff-9f66-4e57-bf11-71c02ca7baf0","added_by":"auto","created_at":"2025-11-10 10:16:46","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":39762,"visible":true,"origin":"","legend":"","description":"","filename":"tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/d3b5799a3dccc127e0037705.docx"},{"id":95529519,"identity":"3147fade-707f-401d-9196-4bac590b38f4","added_by":"auto","created_at":"2025-11-10 10:17:12","extension":"json","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10042,"visible":true,"origin":"","legend":"","description":"","filename":"09b7bc3a87b84286b6b20be13f20db34.json","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/29d896f5d3844c0c880a7e11.json"},{"id":95529874,"identity":"57ee72c3-db65-451a-9a11-1e95f509bf67","added_by":"auto","created_at":"2025-11-10 10:17:34","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":257150,"visible":true,"origin":"","legend":"","description":"","filename":"09b7bc3a87b84286b6b20be13f20db341enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/f3703b49f16b9c099bc4d11c.xml"},{"id":95520618,"identity":"53334e09-2b77-48b9-8e71-b535e52d8121","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"zip","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":2643493,"visible":true,"origin":"","legend":"","description":"","filename":"figures.zip","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/d77d05e8acf72d690301b671.zip"},{"id":95529506,"identity":"cd92ff31-1d78-4a60-8f16-ca1a66a323a1","added_by":"auto","created_at":"2025-11-10 10:17:11","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":256091,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/48c89d60217cf2cf4bdcbfa8.png"},{"id":95520597,"identity":"7aead12a-5a30-4f0e-b297-6751e9e371e8","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/52249626ced7f00c0e8ef89f.png"},{"id":95520599,"identity":"279ee4b8-e229-4029-91db-cd557d98c017","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/fb199f968c2d9d6fbc2e1f6e.png"},{"id":95529819,"identity":"19ab178c-18ff-4d1a-a2df-bb484e96924e","added_by":"auto","created_at":"2025-11-10 10:17:32","extension":"png","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/2216b7df7dea8c17efdcc0da.png"},{"id":95529915,"identity":"75ae0f1f-a25e-4a6a-84bc-8286c571fb3f","added_by":"auto","created_at":"2025-11-10 10:17:41","extension":"png","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/2ec65d11c897dc5983fab22d.png"},{"id":95529760,"identity":"d5faf0c1-697a-40cd-92ae-6412232d38c2","added_by":"auto","created_at":"2025-11-10 10:17:31","extension":"png","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/20f4a9a45d059c408053e9fb.png"},{"id":95529344,"identity":"b58a930c-c98c-45a2-bc06-4e78e0ca10e8","added_by":"auto","created_at":"2025-11-10 10:17:01","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/a29d396e4ab5746eb1d787b3.png"},{"id":95520602,"identity":"9fba47b1-37b8-4c13-82d3-735635b6bd18","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/3287cbe1e5a6fd9b4baa3df9.png"},{"id":95520608,"identity":"35390fb2-9f99-4da4-aa49-0ca66bf9b6bc","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/aa7b071d578fd30e77f876bf.png"},{"id":95529379,"identity":"af97771b-b58a-4399-a966-27019b9e94c9","added_by":"auto","created_at":"2025-11-10 10:17:02","extension":"png","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/fa3ff4b5824f25339440e642.png"},{"id":95520610,"identity":"9595afad-e09b-4239-863e-e8da2f0767eb","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/dbe96a48136e7c348edf707a.png"},{"id":95529573,"identity":"3276a56f-21a2-4373-a806-cf5314ea66d0","added_by":"auto","created_at":"2025-11-10 10:17:14","extension":"png","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":191908,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/2e1cb1daf90b0a8563d70226.png"},{"id":95529931,"identity":"21212996-707b-44f2-929b-0b96340f881d","added_by":"auto","created_at":"2025-11-10 10:17:43","extension":"png","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/e9182f421ba1b8162dfd63b5.png"},{"id":95528420,"identity":"198774dc-8acd-4786-819a-166f8183ac1d","added_by":"auto","created_at":"2025-11-10 10:16:03","extension":"png","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":47840,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage21.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/37170d65ca6999d9d883ef69.png"},{"id":95529000,"identity":"27028a6f-9802-4f69-ad7d-fa3edd8f0f64","added_by":"auto","created_at":"2025-11-10 10:16:42","extension":"png","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":122167,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/870e89cb94d1cf1d88132f2b.png"},{"id":95520614,"identity":"b612fcc0-656b-49f9-95fe-41331be306c8","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":208633,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/fae3cd08b5346118dfb73124.png"},{"id":95529749,"identity":"205f7af9-300f-4e47-8a91-ce6648ea0569","added_by":"auto","created_at":"2025-11-10 10:17:28","extension":"jpeg","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":144439,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/ee51cc6d5be061504eacf22d.jpeg"},{"id":95529880,"identity":"df92b6e1-96ab-4d44-9617-fdf4956bf112","added_by":"auto","created_at":"2025-11-10 10:17:36","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/65ffc0991c75ae2f9ebe45ac.png"},{"id":95529787,"identity":"4e21954f-13e3-4e7b-94db-c1a2a0fb1ed3","added_by":"auto","created_at":"2025-11-10 10:17:32","extension":"jpeg","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22300,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/448047852017514fffc8a50c.jpeg"},{"id":95520613,"identity":"11b71314-8d81-4839-99ab-a985ecb2d695","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/26cff565e78e18daa5221814.png"},{"id":95529606,"identity":"d0566948-26b7-4b36-afa6-d9c1e8f25ab5","added_by":"auto","created_at":"2025-11-10 10:17:17","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":924,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/de0c8bd8636b7952623abc7a.png"},{"id":95520621,"identity":"845a7c4e-188e-4edf-9afc-5781984d025a","added_by":"auto","created_at":"2025-11-10 09:20:29","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":48947,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/581a4dc3bfd37a3878965f9f.png"},{"id":95528975,"identity":"15e6f576-f741-4919-bf2c-cb724920aeb9","added_by":"auto","created_at":"2025-11-10 10:16:39","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/19fffd9d7fe14c6aa82cef81.png"},{"id":95529664,"identity":"a200d34d-f450-41eb-a38c-deb923faab08","added_by":"auto","created_at":"2025-11-10 10:17:21","extension":"png","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/d08ea186bd317d60a4574317.png"},{"id":95529151,"identity":"ddae00fd-c1fc-4559-87f0-36ba5f202c00","added_by":"auto","created_at":"2025-11-10 10:16:50","extension":"png","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/a255c0de4f4af5d63f3d33f5.png"},{"id":95520624,"identity":"b370696a-f240-4864-b074-410f495a82af","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":31,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/4df5d1d289bf11fe0abd3b0e.png"},{"id":95529569,"identity":"5fd1eafe-7b10-4a32-abc9-fd7746b5413f","added_by":"auto","created_at":"2025-11-10 10:17:14","extension":"png","order_by":32,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/7f3092ed68523f46dddd7011.png"},{"id":95520629,"identity":"be348f08-efcf-4171-bf60-984bd6e39da3","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":33,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/a1e3df37b5d2fb160051721b.png"},{"id":95520630,"identity":"5bde9ce2-925c-49be-8d8d-eaaca94f4a4b","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":34,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/bda9e95ef8d6a4a4dffef797.png"},{"id":95528966,"identity":"37e3fcb0-16b4-4f7e-88fc-631eea05432a","added_by":"auto","created_at":"2025-11-10 10:16:38","extension":"png","order_by":35,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/1d3b07182e06b5e33388c689.png"},{"id":95520627,"identity":"946e07ee-d56c-498a-b100-ae7231bcec13","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":36,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/1b15640246080e08cb8a53e6.png"},{"id":95520634,"identity":"824416b7-7900-415e-ab9e-d8ec88f926af","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":37,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/080834f8431c0149a77fbdfa.png"},{"id":95529631,"identity":"f5535774-7ecd-42f2-b92b-00e5f2001e31","added_by":"auto","created_at":"2025-11-10 10:17:19","extension":"png","order_by":38,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":67379,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/a83aac1bda6f3b7e5bc92541.png"},{"id":95528919,"identity":"216f41da-9ae3-4dca-b434-07c05e7c35c0","added_by":"auto","created_at":"2025-11-10 10:16:36","extension":"png","order_by":39,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/d4e99a2e025f9b6c68edc4e1.png"},{"id":95529395,"identity":"5792c492-5b38-40b5-b103-02dd5796026e","added_by":"auto","created_at":"2025-11-10 10:17:03","extension":"png","order_by":40,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14770,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage21.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/35728c40bad691b4a9d0fb42.png"},{"id":95529725,"identity":"2bfed332-ae56-4f40-8902-0504106ceeb0","added_by":"auto","created_at":"2025-11-10 10:17:26","extension":"png","order_by":41,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26218,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/e1672415780f3551d4ec3c37.png"},{"id":95529633,"identity":"5fcd5a2e-2081-455e-b780-1af532a738ed","added_by":"auto","created_at":"2025-11-10 10:17:19","extension":"png","order_by":42,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":36052,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/af99183365cfc20aec0c3e73.png"},{"id":95520638,"identity":"7f723730-27ed-41da-9f8b-a0aa3f770aef","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":43,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":25479,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/a9e5eab609494e126cc7d736.png"},{"id":95529718,"identity":"a5f4e0b3-bf7b-4108-9044-bde2d888a487","added_by":"auto","created_at":"2025-11-10 10:17:25","extension":"png","order_by":44,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/e77326458bcec890bcc073c2.png"},{"id":95529419,"identity":"ffbe3716-9e9e-4efb-af38-81028bc65073","added_by":"auto","created_at":"2025-11-10 10:17:05","extension":"png","order_by":45,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5725,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/577b98a696a318d39db784f2.png"},{"id":95529296,"identity":"4cf55eda-8e83-42a7-9ee1-ac9ef834f4fe","added_by":"auto","created_at":"2025-11-10 10:16:57","extension":"png","order_by":46,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/fbe83610d2718f0fedaa91c0.png"},{"id":95520642,"identity":"a11e94dd-5df9-4f30-a58c-b6bb20e6e345","added_by":"auto","created_at":"2025-11-10 09:20:30","extension":"png","order_by":47,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":388,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/4633fbdb2219e602c341e0f9.png"},{"id":95528768,"identity":"81db7094-d105-49f0-8442-2ffd28f14090","added_by":"auto","created_at":"2025-11-10 10:16:27","extension":"xml","order_by":48,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":254619,"visible":true,"origin":"","legend":"","description":"","filename":"09b7bc3a87b84286b6b20be13f20db341structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/95291a89ed12f2251a3e34e0.xml"},{"id":95529558,"identity":"56ea2259-cc2f-48bb-b749-7cc250a73b28","added_by":"auto","created_at":"2025-11-10 10:17:13","extension":"html","order_by":49,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":263719,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1/d95d86ff7752dcb2b9399bed.html"},{"id":105365278,"identity":"99c19d38-86b4-406b-b407-25735707689b","added_by":"auto","created_at":"2026-03-25 08:29:10","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1875605,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7769855/v1_covered_299f9f73-9968-4a7b-912d-f96e9e7d4af8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Habitat Radiomics Outperforms Whole-Placenta Analysis for Predicting Placenta Accreta Spectrum Disorders on T2WI: A Multicenter Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Placenta accreta spectrum disorders, Habitat, Radiomics","lastPublishedDoi":"10.21203/rs.3.rs-7769855/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7769855/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCurrent MRI diagnosis of Placenta Accreta Spectrum is limited by subjective interpretation and whole-placenta radiomics that miss key local features. This multicenter study tests whether radiomics targeting the specific placental invasion site (\"placental habitat\") on T2WI outperforms both whole-placenta analysis and expert assessment.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eThis multicenter retrospective study enrolled three cohorts for model training, internal validation, and independent external testing. A total of 597 pregnant women with suspected placenta accreta spectrum disorders were included, with Center A contributing 481 cases, Center B providing 68 cases, and Center C contributing 48 cases. Among these, 10 cases from Center A and all cases from Center C were combined to form an independent external test set. The remaining 539 cases from Centers A and B constituted the development cohort, which was randomly divided in a stratified manner into a training set of 377 cases and a validation set of 162 cases. Radiomics features were extracted from two regions: (1) whole-placenta regions and (2) habitat-defined subregions (identified via K-means clustering on T2WI). Four predictive models were developed: a clinical model (incorporating clinical risk factors), a Radiomics model (using whole-placenta features), a habitat model (utilizing habitat-specific features), and a combined model (integrating clinical and habitat features). Performance was benchmarked against assessments by junior and senior radiologists. Model evaluation was conducted using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) as the primary metric.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eIn the training cohort, the AUC values were as follows: junior radiologists (0.601), senior radiologists (0.620), the clinical model (0.841), the Radiomics model (0.777), the habitat model (0.885), and the combined model (0.896). In the validation cohort, the corresponding AUC values were: junior radiologists (0.532), senior radiologists (0.551), the clinical model (0.819), the Radiomics model (0.717), the habitat model (0.862), and the combined model (0.876). In the external test cohort, the AUC values were: junior radiologists (0.570), senior radiologists (0.625), the clinical model (0.814), the Radiomics model (0.751), the habitat model (0.812), and the combined model (0.823).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eHabitat Radiomics consistently outperformed both whole-placenta analysis and radiologist assessment across all cohorts. The habitat model achieved the highest standalone performance (AUC: 0.862\u0026ndash;0.885), demonstrating superior robustness and generalizability for PAS prediction. Integration of clinical features further enhanced performance (combined model AUC: 0.823\u0026ndash;0.896).\u003c/p\u003e","manuscriptTitle":"Habitat Radiomics Outperforms Whole-Placenta Analysis for Predicting Placenta Accreta Spectrum Disorders on T2WI: A Multicenter Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-10 09:20:24","doi":"10.21203/rs.3.rs-7769855/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b39926c3-5a89-4b08-ad91-1ed389626a0b","owner":[],"postedDate":"November 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-25T08:25:58+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-10 09:20:24","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7769855","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7769855","identity":"rs-7769855","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}