Predicting response toneoadjuvant chemotherapy in cervical cancer: possibilities of radiomic analysis of MR images
Solopova А.Е., Bendzhenova B.B., Khokhlova S.V.
Objective: To develop and validate a radiomic model for predicting tumor response to neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC) based on MR imaging.
Materials and methods: A total of 182 patients aged 27 to 49 years with disease stages IB3-IIB and IIIC1 (two patients with metastatic pelvic lymph node involvement) according to FIGO 2018 were retrospectively enrolled in the study. The patients underwent treatment at the Academician Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow from 2018 to 2023. Radiomic parameters were extracted from T2-weighted (T2-WI) and diffusion-weighted (DWI) MR images. The most statistically significant characteristics were selected using LASSO (Least Absolute Shrinkage and Selection Operator) linear regression. The construction of the prediction model was based on a combination of radiomic signs and clinical data. In order to assess the prognostic effectiveness and clinical benefit of the developed model, ROC and decision curve analysis were used.
Results: Two models for predicting response to NACT were developed in the study. The first model included isolated radiomic signs and demonstrated a sensitivity of 79.6% in the main and 85.7% in the test group, specificity 80.6% and 72.1%, respectively. AUC was 0.90 in the main group and 0.83 in the validation group. In order to improve the quality of the model, clinical data (maximum linear size and degree of tumor differentiation, age of the patients, presence of metastatic lymphatic nodes) were included in the nomogram in addition to radiomic parameters. Radiomic nomogram showed sensitivity of 87.8% and 71.4%; specificity of 88.8% and 97.7% in the main and test groups, respectively. AUC was 0.96 and 0.94.
Conclusion: The constructed radiomic model is effective in predicting the therapeutic response of NACT in cervical cancer.
Authors’ contributions: Solopova A.E. – developing the concept of the publication; Bendzhenova B.B., Solopova A.E. – collecting and analyzing the sources, writing, editing the text of the article; Khokhlova S.V. – collecting and processing the material, checking the critical content, approving the final version of the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The work was supported by the Russian Science Foundation grant “Development of technology for objective assessment of tumor progression potential in cervical cancer in order to create new approaches to the study of individual pathogenetic mechanisms of resistance to therapy using quantitative imaging methods, search for markers of treatment efficacy using mathematical modeling on real clinical data.” (No. 23-25-00445 dated of 24.01.2023).
Ethical Approval: The study was approved by the Ethical Review Board of Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: All patients participating in the study provided an informed consent for the publication of their data and associated images.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Solopova А.Е., Bendzhenova B.B., Khokhlova S.V.
Predicting response toneoadjuvant chemotherapy in cervical cancer: possibilities of radiomic analysis of MR images.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (12): 139-147 (in Russian)
https://dx.doi.org/10.18565/aig.2024.311
Keywords
nomogram
cervical cancer
neoadjuvant chemotherapy
radiomics
References
- Bray F., Laversanne M., Sung H., Ferlay J., Siegel R.L., Soerjomataram I. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2024; 74(3):229-63. https://dx.doi.org/10.3322/caac.21834.
- Abu-Rustum N.R., Yashar C.M., Bean S., Bradley K., Campos S.M., Chon H.S. et al. NCCN Guidelines Insights: Cervical Cancer, Version 1.2020. J. Natl. Compr. Canc. Netw. 2020; 18(6): 660-6. https://dx.doi.org/10.6004/jnccn.2020.0027.
- Panici P.B., Di Donato V., Palaia I., Visentin V.S., Marchetti C., Perniola G. et al. Type B versus Type C radical hysterectomy after neoadjuvant chemotherapy in locally advanced cervical carcinoma: a propensity-matched analysis. Ann. Surg. Oncol. 2016; 23(7): 2176-82. https://dx.doi.org/10.1245/s10434-015-4996-z.
- Valentini A.L., Miccò M., Gui B., Giuliani M., Rodolfino E., Telesca A.M. et al. The PRICE study: The role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery. Eur. Radiol. 2018; 28(6): 2425-35. https://dx.doi.org/10.1007/s00330-017-5233-x.
- Рубцова Н.А., Березовская Т.П., Быченко В.Г., Павловская Е.А., Солопова А.Е., Агабабян Т.А., Ходжибекова М.М., Рыжкова Д.В., Чекалова М.А., Мешкова И.Е., Гажонова В.Е., Гус А.И., Багненко С.С., Медведева Б.М., Ашрафян Л.А., Новикова Е.Г., Берлев И.В., Демидова Л.В., Крикунова Л.И., Коломиец Л.А. Лучевая диагностика рака шейки матки. Консенсус экспертов. Медицинская визуализация. 2024; 28(1):141-56. [Rubtsova N.A., Berezovskaia T.P., Bychenko V.G., Pavlovskaya E.A., Solopova A.E., Agababyan T.A., Khodzhibekova M.M., Ryzhkova D.V., Chekalova M.A., Meshkova I.E., Gazhonova V.E., Gus A.I., Bagnenko S.S., Medvedeva B.M., Ashrafyan L.A., Novikova E.G., Berlev I.V., Demidova L.V., Krikunova L.I., Kolomiets L.A. Imaging of cervical cancer. Consensus of experts. Medical Visualization. 2024; 28(1): 141-56. (in Russian)]. https://dx.doi.org/10.24835/1607-0763-1341.
- Gadducci A., Cosio S. Neoadjuvant chemotherapy in locally advanced cervical cancer: review of the literature and perspectives of clinical research. Anticancer. Res. 2020; 40(9): 4819-28. https://dx.doi.org/10.21873/anticanres.14485.
- Wang Y.C., Hu D.Y., Hu X.M., Shen Y.Q., Meng X.Y., Tang H. et al. Assessing the early response of advanced cervical cancer to neoadjuvant chemotherapy using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging: A pilot study. Chin. Med. J. (Engl.). 2016; 129(6): 665-71. https://dx.doi.org/10.4103/0366-6999.177995.
- Dolciami M., Capuani S., Celli V., Maiuro A., Pernazza A., Palaia I. et al. Intravoxel Incoherent Motion (IVIM) MR quantification in locally advanced cervical cancer (LACC): preliminary study on assessment of tumor aggressiveness and response to neoadjuvant chemotherapy. J. Pers. Med. 2022; 12(4): 638. https://dx.doi.org/10.3390/jpm12040638.
- Li M., Zhang J., Dan Y., Yao Y., Dai W., Cai G. et al. A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer. J. Transl. Med. 2020; 18(1): 46. https://dx.doi.org/10.1186/s12967-020-02215-0.
- Ciolina M., Vinci V., Villani L., Gigli S., Saldari M., Panici P.B. et al. Texture analysis versus conventional MRI prognostic factors in predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced cancer of the uterine cervix. Radiol. Med. 2019; 124(10): 955-64. https://dx.doi.org/10.1007/s11547-019-01055-3.
- Sun C., Tian X., Liu Z., Li W., Li P., Chen J. et al. Radiomic analysis for pretreatment prediction of response to neoadjuvant chemotherapy in locally advanced cervical cancer: A multicentre study. EBioMedicine. 2019; 46: 160-9. https://dx.doi.org/10.1016/j.ebiom.2019.07.049.
Received 05.12.2024
Accepted 11.12.2024
About the Authors
Alina E. Solopova, Dr. Med. Sci., Leading Researcher at the Radiology Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4; Professor at the Department of Obstetrics, Gynecology and Perinatal Medicine, Sechenov University, Ministry of Health of Russia, dr.solopova@mail.ru, Scopus Author ID: 24460923200. Researcher ID: P-8659-2015, https://orcid.org/0000-0003-4768-115XBova B. Bendzhenova, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, https://orcid.org/0009-0004-4744-0422
Svetlana V. Khokholova, Dr. Med. Sci., Head of Department of Antitumor Drug Therapy, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, https://orcid.org/0000-0002-4121-7228
Corresponding author: Alina E. Solopova, dr.solopova@mail.ru
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