Abstract

ObjectivesTo evaluate the predictive value of radiomics features based on multiparameter magnetic resonance imaging (MP-MRI) for peritoneal carcinomatosis (PC) in patients with ovarian cancer (OC).MethodsA total of 86 patients with epithelial OC were included in this retrospective study. All patients underwent FS-T2WI, DWI, and DCE-MRI scans, followed by total hysterectomy plus omentectomy. Quantitative imaging features were extracted from preoperative FS-T2WI, DWI, and DCE-MRI images, and feature screening was performed using a minimum redundancy maximum correlation (mRMR) and least absolute shrinkage selection operator (LASSO) methods. Four radiomics models were constructed based on three MRI sequences. Then, combined with radiomics characteristics and clinicopathological risk factors, a multi-factor Logistic regression method was used to construct a radiomics nomogram, and the performance of the radiomics nomogram was evaluated by receiver operating characteristic curve (ROC) curve, calibration curve, and decision curve analysis.ResultsThe radiomics model from the MP-MRI combined sequence showed a higher area under the curve (AUC) than the model from FS-T2WI, DWI, and DCE-MRI alone (0.846 vs. 0.762, 0.830, 0.807, respectively). The radiomics nomogram (AUC=0.902) constructed by combining radiomics characteristics and clinicopathological risk factors showed a better diagnostic effect than the clinical model (AUC=0.858) and the radiomics model (AUC=0.846). The decision curve analysis shows that the radiomics nomogram has good clinical application value, and the calibration curve also proves that it has good stability.ConclusionRadiomics nomogram based on MP-MRI combined sequence showed good predictive accuracy for PC in patients with OC. This tool can be used to identify peritoneal carcinomatosis in OC patients before surgery.

Highlights

  • Ovarian cancer (OC) is the fifth most common cancer in women and the most common gynecological tumor

  • This study evaluated the value of multi-parameter MRI radiomics in predicting preoperative peritoneal carcinomatosis in patients with ovarian cancer

  • Decision curves were used to compare the benefits of nomograms, radiomics models, and clinical models, and we found that when the threshold probability of Decision curve analysis (DCA) curves was 37%-85%, nomograms had better predictive performance than clinical models and omics models (Figure 6B)

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Summary

Introduction

Ovarian cancer (OC) is the fifth most common cancer in women and the most common gynecological tumor. Epithelial ovarian cancer (EOC) is the most common OC subtype accounting for 90% of all OC. It is characterized by extensive and rapid intra-abdominal carcinomatosis and has a poor prognosis and high mortality. The 5-year survival rate of EOC is only 30% [1,2,3,4]. If the patient can detect PC at an early stage, it will be able to buy sufficient treatment time for the patient and effectively control the patient’s condition from further deterioration. Preoperative detection of peritoneal carcinomatosis (PC) is essential to avoid unnecessary resection and choose the best treatment method for patients with EOC

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