Predicting Risk Stratification in Early-Stage Endometrial Carcinoma: Significance of Multiparametric MRI Radiomics Model.

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This study developed multiparametric MRI radiomics models to predict risk stratification and staging accuracy in early-stage endometrial carcinoma, outperforming radiologist performance.

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This study developed a multiparametric MRI radiomics model to predict risk stratification and staging in 155 patients with early-stage endometrial carcinoma. By extracting features from T2WI, CE-T1WI, and ADC sequences and applying a multilayer perceptron algorithm, the combined model achieved high accuracy for both risk assessment and tumor staging, outperforming individual sequences and radiologist evaluations. The authors conclude that this integrated radiomics approach offers a precise tool for preoperative clinical decision-making in these cases. This paper is centrally about endometriosis and adenomyosis research only insofar as it addresses endometrial carcinoma, a distinct malignancy of the uterine lining often discussed in gynecologic oncology contexts alongside benign conditions like adenomyosis, but it does not investigate endometriosis or adenomyosis pathology.

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Abstract

Endometrial carcinoma (EC) risk stratification prior to surgery is crucial for clinical treatment. In this study, we intend to evaluate the predictive value of radiomics models based on magnetic resonance imaging (MRI) for risk stratification and staging of early-stage EC. The study included 155 patients who underwent MRI examinations prior to surgery and were pathologically diagnosed with early-stage EC between January, 2020, and September, 2022. Three-dimensional radiomics features were extracted from segmented tumor images captured by MRI scans (including T2WI, CE-T1WI delayed phase, and ADC), with 1521 features extracted from each of the three modalities. Then, using five-fold cross-validation and a multilayer perceptron algorithm, these features were filtered using Pearson's correlation coefficient to develop a prediction model for risk stratification and staging of EC. The performance of each model was assessed by analyzing ROC curves and calculating the AUC, accuracy, sensitivity, and specificity. In terms of risk stratification, the CE-T1 sequence demonstrated the highest predictive accuracy of 0.858 ± 0.025 and an AUC of 0.878 ± 0.042 among the three sequences. However, combining all three sequences resulted in enhanced predictive accuracy, reaching 0.881 ± 0.040, with a corresponding increase in the AUC to 0.862 ± 0.069. In the context of staging, the utilization of a combination involving T2WI with CE-T1WI led to a notably elevated predictive accuracy of 0.956 ± 0.020, surpassing the accuracy achieved when employing any singular feature. Correspondingly, the AUC was 0.979 ± 0.022. When incorporating all three sequences concurrently, the predictive accuracy reached 0.956 ± 0.000, accompanied by an AUC of 0.986 ± 0.007. It is noteworthy that this level of accuracy surpassed that of the radiologist, which stood at 0.832. The MRI radiomics model has the potential to accurately predict the risk stratification and early staging of EC.
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Abstract

Endometrial carcinoma (EC) risk stratification prior to surgery is crucial for clinical treatment. In this study, we intend to evaluate the predictive value of radiomics models based on magnetic resonance imaging (MRI) for risk stratification and staging of early-stage EC. The study included 155 patients who underwent MRI examinations prior to surgery and were pathologically diagnosed with early-stage EC between January, 2020, and September, 2022. Three-dimensional radiomics features were extracted from segmented tumor images captured by MRI scans (including T2WI, CE-T1WI delayed phase, and ADC), with 1521 features extracted from each of the three modalities. Then, using five-fold cross-validation and a multilayer perceptron algorithm, these features were filtered using Pearson’s correlation coefficient to develop a prediction model for risk stratification and staging of EC. The performance of each model was assessed by analyzing ROC curves and calculating the AUC, accuracy, sensitivity, and specificity. In terms of risk stratification, the CE-T1 sequence demonstrated the highest predictive accuracy of 0.858 ± 0.025 and an AUC of 0.878 ± 0.042 among the three sequences. However, combining all three sequences resulted in enhanced predictive accuracy, reaching 0.881 ± 0.040, with a corresponding increase in the AUC to 0.862 ± 0.069. In the context of staging, the utilization of a combination involving T2WI with CE-T1WI led to a notably elevated predictive accuracy of 0.956 ± 0.020, surpassing the accuracy achieved when employing any singular feature. Correspondingly, the AUC was 0.979 ± 0.022. When incorporating all three sequences concurrently, the predictive accuracy reached 0.956 ± 0.000, accompanied by an AUC of 0.986 ± 0.007. It is noteworthy that this level of accuracy surpassed that of the radiologist, which stood at 0.832. The MRI radiomics model has the potential to accurately predict the risk stratification and early staging of EC. Similar content being viewed by others Availability of Data and Materials All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

References

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Acknowledgements

We are particularly grateful to all the people who have given us help on our article. Funding This work was supported by the Outstanding Young Scientific Research and Innovation Team of Hebei University (605020521007); The Youth Scientific research fund of Affiliated Hospital of Hebei University (2019Q041); a preliminary study on the correlation between functional MRI parameters and Ki-67 in endometrial carcinoma, Baoding Science and Technology Bureau project (2041ZF132). Author information Authors and Affiliations Contributions Conception and design of the research: Huan Meng, Jia-Ning Wang, Xiao-Ping Yin, and Lin-Yan Xue. Acquisition of data: Huan Meng, Yu Zhang, Ya-Nan Yu, and Jing Wang. Analysis and interpretation of the data: Huan Meng, Yu-Feng Sun, Jing Wang, and Ya-Nan Yu. Statistical analysis: Huan Meng, Yu-Feng Sun, Yu Zhang, and Lin-Yan Xue. Obtaining financing: Huan Meng, Xiao-Ping Yin, and Jia-Ning Wang. Writing of the manuscript: Huan Meng. Critical revision of the manuscript for intellectual content: Xiao-Ping Yin. All authors read and approved the final draft. Corresponding authors Ethics declarations Ethics Approval and Consent to Participate The study was conducted in accordance with the Declaration of Helsinki (as was revised in 2013). The study was approved by Ethics Committee of the Affiliated Hospital of Hebei University (No.HDFY-LL-2019–042). Written informed consent was obtained from all participants. Competing Interests The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Huan Meng and Yu-Feng Sun contributed equally to this study Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Meng, H., Sun, YF., Zhang, Y. et al. Predicting Risk Stratification in Early-Stage Endometrial Carcinoma: Significance of Multiparametric MRI Radiomics Model. J Digit Imaging. Inform. med. 37, 81–91 (2024). https://doi.org/10.1007/s10278-023-00936-4 Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10278-023-00936-4

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