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MRI-radiomics-clinical-based nomogram for prenatal prediction of the placenta accreta spectrum disorders
Lulu Peng1,2,3, Xiang Zhang4, Jue Liu1,2,3
1Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 Duobao Road, Guangzhou, 510000, People's Republic of China.
Objectives:
To investigate whether an MRI-radiomics-clinical-based nomogram can be used to prenatal predict the placenta accreta spectrum (PAS) disorders.
Methods:
The pelvic MR images and clinical data of 156 pregnant women with pathologic-proved PAS (PAS group) and 115 pregnant women with no PAS (non-PAS group) identified by clinical and prenatal ultrasonic examination were retrospectively collected from two centers. These pregnancies were divided into a training (n = 133), an independent validation (n = 57), and an external validation (n = 81) cohort. Radiomic features were extracted from images of transverse oblique T2-weighted imaging. A radiomics signature was constructed. A nomogram, composed of MRI morphological findings, radiomic features, and prenatal clinical characteristics, was developed. The discrimination and calibration of the nomogram were conducted to assess its performance.
Results:
A radiomics signature, including three PAS-related features, was associated with the presence of PAS in the three cohorts (p < 0.001 to p = 0.001). An MRI-radiomics-clinical nomogram incorporating radiomics signature, two prenatal clinical features, and two MRI morphological findings was developed, yielding a higher area under the curve (AUC) than that of the MRI morphological-determined PAS in the training cohort (0.89 vs. 0.78; p < 0.001) and external validation cohort (0.87 vs. 0.75; p = 0.003), while a comparable AUC value in the validation cohort (0.91 vs. 0.81; p = 0.09). The calibration was good.
Conclusions:
An MRI-radiomics-clinical nomogram had a robust performance in antenatal predicting the PAS in pregnancies.
Key Points:
• An MRI-radiomics-clinical-based nomogram might serve as an adjunctive approach for the treatment decision-making in pregnancies suspicious of PAS. • The radiomic score provides a mathematical formula that predicts the possibility of PAS by using the MRI data, and pregnant women with PAS had higher radiomic scores than those without PAS.
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