1Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China; 2Department of Radiology, West Branch of the First Affiliated Hospital of University of Science and Technology of China, Hefei 230031, China
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 T2WI) 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.
Zhang Yu,Zhang Kaiyue,Jia Haodong et al. Nomogram based on IVIM‐DWI and radiomics in predicting recurrence after concurrent chemoradiotherapy for patients with cervical cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(10): 897-903.
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