An MR- based radiomics nomogram including information from the peritumoral region to predict deep myometrial invasion in stage I endometrioid adenocarcinoma: a preliminary study

Objective: To develop and validate an MR -based radiomics nomogram combining different imaging sequences (ADC mapping and T2 weighted imaging (T2WI)), different tumor regions (combined intraand peritumoral regions), and different parameters (clinical features, tumor morphological features, and radiomics features) while considering different MR field strengths in predicting deep myometrial invasion (MI) in Stage I endometrioid adenocarcinoma (EEA). Methods: A total of 202 patients were retrospectively analyzed and divided into two cohorts (training cohort, 1.5 T MR, n = 131; validation cohort, 3.0 T MR, n = 71). Axial ADC mapping and T2WI were conducted. Radiomics features were extracted from intraand peritumoral regions. Least absolute shrinkage and selection operator regression, univariate analysis, and multivariate logistic regression were used to select radiomics features and tumor morphological and clinical parameters. The area under the receiver operator characteristic curve (AUC) was calculated to evaluate the performance of the prediction model and radiomics nomogram. Results: Ten radiomics features, 4 morphological parameters and 1 clinical characteristic were selected. The radiomics nomogram achieved good discrimination between the superficial and deep MI cohorts. The AUC was 0.927 (95% confidence interval [CI]: 0.865, 0.967) in the training cohort and 0.921 (95% CI: 0.872, 0.948) in the validation cohort. The specificity and sensitivity were 92.0 and 78.9% in the training cohort and 83.0 and 77.8% in the validation cohort, respectively. Conclusion: The radiomics nomogram showed good performance in predicting the depth of MI in Stage I EEA before surgery and might be useful for surgical patient management. Advances in knowledge: An MR -based radiomics nomogram was useful for predicting deep MI in Stage I EEA patients (AUCtrain = 0.927, AUCvalidation = 0.921). The intraand peritumoral radiomics features complemented each other. The nomogram was developed and validated with different MR field strengths, suggesting that the model demonstrates good generalizability.