Nomogram based on IVIM-DWI and radiomics in predicting recurrence after concurrent chemoradiotherapy for patients with cervical cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective:To investigate the value of nomogram based on intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and MRI-derived radiomics for predicting recurrence after concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods:Clinical data of 111 patients with ⅠB-ⅣA cervical cancer who underwent CCRT at Anhui Provincial Hospital from December 2014 to December 2019 and were continuously followed up were retrospectively analyzed. Pre-treatment IVIM-DWI parameters (ADC, D, D * and f) and pre- and post-treatment 3D texture parameters (from axial T 2WI) of the primary lesions were measured. Least absolute shrinkage and selection operator (LASSO) algorithm and multivariate logistic regression analysis were used to filter texture features and calculate radiomics score (Rad-score). A Cox regression model was used to analyze independent risk factors for recurrence after CCRT in patients with LACC and construct a nomogram. Results:External beam radiotherapy dose, f value , pre-treatment Rad-score and post-treatment Rad-score ( HR=0.204, 3.253, 2.544, 7.576) were the independent prognostic factors for recurrence after CCRT in cervical cancer patients and jointly formed the nomogram. The area under curve (AUC) of the nomogram for predicting 1-, 3- and 5-year disease-free survival (DFS) was 0.895, 0.888 and 0.916, with internal validation C-indexes of 0.859, 0.903 and 0.867, respectively. The decision curves analysis showed that the nomogram has a higher net clinical benefit compared to other models, and the clinical impact curves further visualized its predictive accuracy. Conclusions:The nomogam based on IVIM-DWI and radiomics has high clinical value in predicting recurrence after CCRT in patients with LACC, providing reference for prognostic assessment and individualized treatment of cervical cancer patients.