A T2-weighted MRI-based radiomic signature for disease-free survival in locally advanced cervical cancer following chemoradiation: An international, multicentre study

Joseph Marsilla ¹, Jessica Weiss ², Xiang Y Ye ²

⁰Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology +

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July 27, 2024

View abstract on PubMed

Summary

A new MRI-based radiomic signature shows promise as a prognostic biomarker for disease-free survival (DFS) in locally advanced cervical cancer patients treated with chemoradiation, aiding in personalized treatment strategies.

Area Of Science

Oncology
Radiology
Medical Imaging

Background

Locally advanced cervical cancer (LACC) requires effective prognostic biomarkers for treatment stratification.
Current prognostic models may not fully capture the complexity of treatment response and survival outcomes.

Purpose Of The Study

To develop and validate a T2-weighted magnetic resonance imaging (MRI)-based radiomic signature.
To assess the signature's association with disease-free survival (DFS) in LACC patients treated with chemoradiation.

Main Methods

Radiomic features were extracted from MRI scans of 132 patients (training) and 199 patients (validation) using PyRadiomics.
A prognostic model for DFS was developed using a minimal redundancy maximum relevancy feature selection method.
Univariate and multivariable Cox regression analyses were performed to evaluate the radiomic signature's prognostic value.

Main Results

The radiomic signature was prognostic for DFS in both training (HR 5.54, p=0.002; HR 3.59, p=0.04) and validation cohorts (HR 2.22, p=0.003; HR 1.84, p=0.04).
The signature remained independently associated with DFS after adjusting for stage and tumor volume.
Significant differences in 4-year DFS rates were observed between patients with high and low radiomic signature scores (e.g., 48.2% vs 87.9% in the training cohort).

Conclusions

An MRI-based radiomic signature serves as a valuable prognostic biomarker for DFS in LACC patients.
This signature can potentially guide treatment decisions and improve patient outcomes in chemoradiation therapy.

Keywords:

Cervical cancer Disease-free survival Magnetic Resonance Imaging Radiogenomics Radiomics