Skip to main content
Erschienen in: European Radiology 1/2021

04.08.2020 | Imaging Informatics and Artificial Intelligence

Radiologists with MRI-based radiomics aids to predict the pelvic lymph node metastasis in endometrial cancer: a multicenter study

verfasst von: Bi Cong Yan, Ying Li, Feng Hua Ma, Guo Fu Zhang, Feng Feng, Ming Hua Sun, Guang Wu Lin, Jin Wei Qiang

Erschienen in: European Radiology | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

To construct a MRI radiomics model and help radiologists to improve the assessments of pelvic lymph node metastasis (PLNM) in endometrial cancer (EC) preoperatively.

Methods

During January 2014 and May 2019, 622 EC patients (age 56.6 ± 8.8 years; range 27–85 years) from five different centers (A to E) were divided into training set, validation set 1 (351 cases from center A), and validation set 2 (271 cases from centers B–E). The radiomics features were extracted basing on T2WI, DWI, ADC, and CE-T1WI images, and most related radiomics features were selected using the random forest classifier to build a radiomics model. The ROC curve was used to evaluate the performance of training set and validation sets, radiologists based on MRI findings alone, and with the aid of the radiomics model. The clinical decisive curve (CDC), net reclassification index (NRI), and total integrated discrimination index (IDI) were used to assess the clinical benefit of using the radiomics model.

Results

The AUC values were 0.935 for the training set, 0.909 and 0.885 for validation sets 1 and 2, 0.623 and 0.643 for the radiologists 1 and 2 alone, and 0.814 and 0.842 for the radiomics-aided radiologists 1 and 2, respectively. The AUC, CDC, NRI, and IDI showed higher diagnostic performance and clinical net benefits for the radiomics-aided radiologists than for the radiologists alone.

Conclusions

The MRI-based radiomics model could be used to assess the status of pelvic lymph node and help radiologists improve their performance in predicting PLNM in EC.

Key Points

• A total of 358 radiomics features were extracted. The 37 most important features were selected using the random forest classifier.
• The reclassification measures of discrimination confirmed that the radiomics-aided radiologists performed better than the radiologists alone, with an NRI of 1.26 and an IDI of 0.21 for radiologist 1 and an NRI of 1.37 and an IDI of 0.24 for radiologist 2.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Straughn JMJ, Huh WK, Kelly FJ et al (2002) Conservative management of stage I endometrial carcinoma after surgical staging. Gynecol Oncol 84:194–200CrossRef Straughn JMJ, Huh WK, Kelly FJ et al (2002) Conservative management of stage I endometrial carcinoma after surgical staging. Gynecol Oncol 84:194–200CrossRef
2.
Zurück zum Zitat Cragun JM, Havrilesky LJ, Calingaert B et al (2005) Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol 23:3668–3675CrossRef Cragun JM, Havrilesky LJ, Calingaert B et al (2005) Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol 23:3668–3675CrossRef
3.
Zurück zum Zitat Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 373:125–136CrossRef Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 373:125–136CrossRef
4.
Zurück zum Zitat Creutzberg CL, van Putten WL, Koper PC et al (2000) Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet 355:1404–1411CrossRef Creutzberg CL, van Putten WL, Koper PC et al (2000) Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet 355:1404–1411CrossRef
5.
Zurück zum Zitat Bi Q, Chen Y, Wu K et al (2020) The diagnostic value of MRI for preoperative staging in patients with endometrial cancer: a meta-analysis. Acad Radiol 27:960–968 Bi Q, Chen Y, Wu K et al (2020) The diagnostic value of MRI for preoperative staging in patients with endometrial cancer: a meta-analysis. Acad Radiol 27:960–968
6.
Zurück zum Zitat Stewart KI, Chasen B, Erwin W et al (2019) Preoperative PET/CT does not accurately detect extrauterine disease in patients with newly diagnosed high-risk endometrial cancer: a prospective study. Cancer 125:3347–3353CrossRef Stewart KI, Chasen B, Erwin W et al (2019) Preoperative PET/CT does not accurately detect extrauterine disease in patients with newly diagnosed high-risk endometrial cancer: a prospective study. Cancer 125:3347–3353CrossRef
7.
Zurück zum Zitat Gillies RJ, Kinahan PE, Hricak H (2016) Radiomics: images are more than pictures, they are data. Radiology 278:563–577CrossRef Gillies RJ, Kinahan PE, Hricak H (2016) Radiomics: images are more than pictures, they are data. Radiology 278:563–577CrossRef
8.
Zurück zum Zitat Kumar V, Gu Y, Basu S et al (2012) Radiomics: the process and the challenges. Magn Reson Imaging 30:1234–1248CrossRef Kumar V, Gu Y, Basu S et al (2012) Radiomics: the process and the challenges. Magn Reson Imaging 30:1234–1248CrossRef
9.
Zurück zum Zitat Lambin P, Rios-Velazquez E, Leijenaar R et al (2012) Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 48:441–446CrossRef Lambin P, Rios-Velazquez E, Leijenaar R et al (2012) Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 48:441–446CrossRef
10.
Zurück zum Zitat Rizzo S, Botta F, Raimondi S et al (2018) Radiomics: the facts and the challenges of image analysis. Eur Radiol Exp 2:36CrossRef Rizzo S, Botta F, Raimondi S et al (2018) Radiomics: the facts and the challenges of image analysis. Eur Radiol Exp 2:36CrossRef
11.
Zurück zum Zitat Ji GW, Zhang YD, Zhang H et al (2019) Biliary tract cancer at CT: a radiomics-based model to predict lymph node metastasis and survival outcomes. Radiology 290:90–98CrossRef Ji GW, Zhang YD, Zhang H et al (2019) Biliary tract cancer at CT: a radiomics-based model to predict lymph node metastasis and survival outcomes. Radiology 290:90–98CrossRef
12.
Zurück zum Zitat Wu S, Zheng J, Li Y et al (2018) Development and validation of an MRI-based radiomics signature for the preoperative prediction of lymph node metastasis in bladder cancer. EBioMedicine 34:76–84CrossRef Wu S, Zheng J, Li Y et al (2018) Development and validation of an MRI-based radiomics signature for the preoperative prediction of lymph node metastasis in bladder cancer. EBioMedicine 34:76–84CrossRef
13.
Zurück zum Zitat Wibmer A, Hricak H, Gondo T et al (2015) Haralick texture analysis of prostate MRI: utility for differentiating non-cancerous prostate from prostate cancer and differentiating prostate cancers with different Gleason scores. Eur Radiol 25:2840–2850CrossRef Wibmer A, Hricak H, Gondo T et al (2015) Haralick texture analysis of prostate MRI: utility for differentiating non-cancerous prostate from prostate cancer and differentiating prostate cancers with different Gleason scores. Eur Radiol 25:2840–2850CrossRef
14.
Zurück zum Zitat Gu D, Hu Y, Ding H et al (2019) CT radiomics may predict the grade of pancreatic neuroendocrine tumors: a multicenter study. Eur Radiol 29:6880–6890CrossRef Gu D, Hu Y, Ding H et al (2019) CT radiomics may predict the grade of pancreatic neuroendocrine tumors: a multicenter study. Eur Radiol 29:6880–6890CrossRef
15.
Zurück zum Zitat Ueno Y, Forghani B, Forghani R et al (2017) Endometrial carcinoma: MR imaging-based texture model for preoperative risk stratification-a preliminary analysis. Radiology 284:748–757CrossRef Ueno Y, Forghani B, Forghani R et al (2017) Endometrial carcinoma: MR imaging-based texture model for preoperative risk stratification-a preliminary analysis. Radiology 284:748–757CrossRef
16.
Zurück zum Zitat De Bernardi E, Buda A, Guerra L et al (2018) Radiomics of the primary tumour as a tool to improve (18)F-FDG-PET sensitivity in detecting nodal metastases in endometrial cancer. EJNMMI Res 8:86CrossRef De Bernardi E, Buda A, Guerra L et al (2018) Radiomics of the primary tumour as a tool to improve (18)F-FDG-PET sensitivity in detecting nodal metastases in endometrial cancer. EJNMMI Res 8:86CrossRef
17.
Zurück zum Zitat Yu C, Jiang X, Li B, Gan L, Huang J (2015) Expression of ER, PR, C-erbB-2 and Ki-67 in endometrial carcinoma and their relationships with the clinicopathological features. Asian Pac J Cancer Prev 16:6789–6794CrossRef Yu C, Jiang X, Li B, Gan L, Huang J (2015) Expression of ER, PR, C-erbB-2 and Ki-67 in endometrial carcinoma and their relationships with the clinicopathological features. Asian Pac J Cancer Prev 16:6789–6794CrossRef
18.
Zurück zum Zitat Gülseren V, Kocaer M, Özdemir İA, Çakır İ, Sancı M, Güngördük K (2020) Do estrogen, progesterone, P53 and Ki67 receptor ratios determined from curettage materials in endometrioid-type endometrial carcinoma predict lymph node metastasis? Curr Probl Cancer 44:100498 Gülseren V, Kocaer M, Özdemir İA, Çakır İ, Sancı M, Güngördük K (2020) Do estrogen, progesterone, P53 and Ki67 receptor ratios determined from curettage materials in endometrioid-type endometrial carcinoma predict lymph node metastasis? Curr Probl Cancer 44:100498
19.
Zurück zum Zitat Orlhac F, Frouin F, Nioche C, Ayache N, Buvat I (2019) Validation of a method to compensate multicenter effects affecting CT radiomics. Radiology 291:53–59CrossRef Orlhac F, Frouin F, Nioche C, Ayache N, Buvat I (2019) Validation of a method to compensate multicenter effects affecting CT radiomics. Radiology 291:53–59CrossRef
20.
Zurück zum Zitat Seo JH, Kim YH (2018) Machine-learning approach to optimize SMOTE ratio in class imbalance dataset for intrusion detection. Comput Intell Neurosci 2018:9704672CrossRef Seo JH, Kim YH (2018) Machine-learning approach to optimize SMOTE ratio in class imbalance dataset for intrusion detection. Comput Intell Neurosci 2018:9704672CrossRef
21.
Zurück zum Zitat Feng Z, Rong P, Cao P et al (2018) Machine learning-based quantitative texture analysis of CT images of small renal masses: differentiation of angiomyolipoma without visible fat from renal cell carcinoma. Eur Radiol 28:1625–1633CrossRef Feng Z, Rong P, Cao P et al (2018) Machine learning-based quantitative texture analysis of CT images of small renal masses: differentiation of angiomyolipoma without visible fat from renal cell carcinoma. Eur Radiol 28:1625–1633CrossRef
22.
Zurück zum Zitat Xu X, Li H, Wang S et al (2019) Multiplanar MRI-based predictive model for preoperative assessment of lymph node metastasis in endometrial cancer. Front Oncol 9:1007CrossRef Xu X, Li H, Wang S et al (2019) Multiplanar MRI-based predictive model for preoperative assessment of lymph node metastasis in endometrial cancer. Front Oncol 9:1007CrossRef
23.
Zurück zum Zitat FIGO Committee on Gynecologic Oncology (2014) FIGO staging for carcinoma of the vulva, cervix, and corpus uteri. Int J Gynaecol Obstet 125:97–98CrossRef FIGO Committee on Gynecologic Oncology (2014) FIGO staging for carcinoma of the vulva, cervix, and corpus uteri. Int J Gynaecol Obstet 125:97–98CrossRef
24.
Zurück zum Zitat Hu J, Zhang K, Yan Y, Zang Y, Wang Y, Xue F (2019) Diagnostic accuracy of preoperative (18)F-FDG PET or PET/CT in detecting pelvic and para-aortic lymph node metastasis in patients with endometrial cancer: a systematic review and meta-analysis. Arch Gynecol Obstet 300:519–529CrossRef Hu J, Zhang K, Yan Y, Zang Y, Wang Y, Xue F (2019) Diagnostic accuracy of preoperative (18)F-FDG PET or PET/CT in detecting pelvic and para-aortic lymph node metastasis in patients with endometrial cancer: a systematic review and meta-analysis. Arch Gynecol Obstet 300:519–529CrossRef
25.
Zurück zum Zitat Bian L, Wang M, Gong J et al (2019) Comparison of integrated PET/MRI with PET/CT in evaluation of endometrial cancer: a retrospective analysis of 81 cases. PeerJ 7:e7081CrossRef Bian L, Wang M, Gong J et al (2019) Comparison of integrated PET/MRI with PET/CT in evaluation of endometrial cancer: a retrospective analysis of 81 cases. PeerJ 7:e7081CrossRef
26.
Zurück zum Zitat Duncan KA, Drinkwater KJ, Frost C, Remedios D, Barter S (2012) Staging cancer of the uterus: a national audit of MRI accuracy. Clin Radiol 67:523–530CrossRef Duncan KA, Drinkwater KJ, Frost C, Remedios D, Barter S (2012) Staging cancer of the uterus: a national audit of MRI accuracy. Clin Radiol 67:523–530CrossRef
27.
Zurück zum Zitat Ytre-Hauge S, Dybvik JA, Lundervold A et al (2018) Preoperative tumor texture analysis on MRI predicts high-risk disease and reduced survival in endometrial cancer. J Magn Reson Imaging 48:1637–1647CrossRef Ytre-Hauge S, Dybvik JA, Lundervold A et al (2018) Preoperative tumor texture analysis on MRI predicts high-risk disease and reduced survival in endometrial cancer. J Magn Reson Imaging 48:1637–1647CrossRef
28.
Zurück zum Zitat Sala E, Mema E, Himoto Y et al (2017) Unravelling tumour heterogeneity using next-generation imaging: radiomics, radiogenomics, and habitat imaging. Clin Radiol 72:3–10CrossRef Sala E, Mema E, Himoto Y et al (2017) Unravelling tumour heterogeneity using next-generation imaging: radiomics, radiogenomics, and habitat imaging. Clin Radiol 72:3–10CrossRef
29.
Zurück zum Zitat Lavaud P, Fedida B, Canlorbe G, Bendifallah S, Darai E, Thomassin-Naggara I (2018) Preoperative MR imaging for ESMO-ESGO-ESTRO classification of endometrial cancer. Diagn Interv Imaging 99:387–396CrossRef Lavaud P, Fedida B, Canlorbe G, Bendifallah S, Darai E, Thomassin-Naggara I (2018) Preoperative MR imaging for ESMO-ESGO-ESTRO classification of endometrial cancer. Diagn Interv Imaging 99:387–396CrossRef
30.
Zurück zum Zitat Cook NR (2007) Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation 115:928–935CrossRef Cook NR (2007) Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation 115:928–935CrossRef
31.
Zurück zum Zitat Talhouk A, McConechy MK, Leung S et al (2015) A clinically applicable molecular-based classification for endometrial cancers. Br J Cancer 113:299–310CrossRef Talhouk A, McConechy MK, Leung S et al (2015) A clinically applicable molecular-based classification for endometrial cancers. Br J Cancer 113:299–310CrossRef
32.
Zurück zum Zitat Fiset S, Welch ML, Weiss J et al (2019) Repeatability and reproducibility of MRI-based radiomic features in cervical cancer. Radiother Oncol 135:107–114CrossRef Fiset S, Welch ML, Weiss J et al (2019) Repeatability and reproducibility of MRI-based radiomic features in cervical cancer. Radiother Oncol 135:107–114CrossRef
Metadaten
Titel
Radiologists with MRI-based radiomics aids to predict the pelvic lymph node metastasis in endometrial cancer: a multicenter study
verfasst von
Bi Cong Yan
Ying Li
Feng Hua Ma
Guo Fu Zhang
Feng Feng
Ming Hua Sun
Guang Wu Lin
Jin Wei Qiang
Publikationsdatum
04.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07099-8

Weitere Artikel der Ausgabe 1/2021

European Radiology 1/2021 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.