Prediction Model of Lymph Node Metastasis in Cervical Cancer Based on MRI Habitat Radiomics

Background: Radiomics provides a non-invasive approach for predicting lymph node metastasis (LNM) in cervical cancer, but conventional whole-tumor analysis often overlooks intratumoral heterogeneity. Methods: This study aimed to develop and validate an MRI-based habitat radiomics model for preoperative prediction of pelvic LNM in early-stage cervical cancer. Tumor regions were delineated on diffusion-weighted imaging, and intratumoral habitats were generated using unsupervised K-means clustering. Radiomic features were extracted from whole tumors and habitat subregions, combined with clinical variables, and selected using correlation analysis and LASSO regression. Four models-clinical, conventional radiomics, habitat radiomics, and combined-were constructed and evaluated. Results: In internal validation, the combined model achieved the best performance (AUC = 0.895), outperforming the clinical (AUC = 0.799), conventional radiomics (AUC = 0.611), and habitat models (AUC = 0.872). Calibration and decision curve analyses demonstrated good agreement and clinical utility. Conclusions: Integrating habitat-based radiomics with clinical factors significantly improves the preoperative prediction of LNM, providing a robust and clinically applicable tool for individualized management of cervical cancer patients.