• Zhicong Li, Hailin Li, Shiyu Wang, Di Dong, Fangfang Yin, An Chen, Siwen Wang, Guangming Zhao, Mengjie Fang, Jie Tian, Sufang Wu, and Han Wang.
• Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
• J Magn Reson Imaging. 2019 May 1; 49 (5): 1420-1426.

BackgroundLymph-vascular space invasion (LVSI) is an unfavorable prognostic factor in cervical cancer. Unfortunately, there are no current clinical tools for the preoperative prediction of LVSI.PurposeTo develop and validate an axial T1 contrast-enhanced (CE) MR-based radiomics nomogram that incorporated a radiomics signature and some clinical parameters for predicting LVSI of cervical cancer preoperatively.Study TypeRetrospective.PopulationIn all, 105 patients were randomly divided into two cohorts at a 2:1 ratio.Field Strength/SequenceT1 CE MRI sequences at 1.5T.AssessmentUnivariate analysis was performed on the radiomics features and clinical parameters. Multivariate analysis was performed to determine the optimal feature subset. The receiver operating characteristic (ROC) analysis was performed to evaluate the performance of prediction model and radiomics nomogram.Statistical TestsThe Mann-Whitney U-test and the chi-square test were used to evaluate the performance of clinical characteristics and LVSI status by pathology. The minimum-redundancy/maximum-relevance and recursive feature elimination methods were applied to select the features. The radiomics model was constructed using logistic regression.ResultsThree radiomics features and one clinical characteristic were selected. The radiomics nomogram showed favorable discrimination between LVSI and non-LVSI groups. The AUC was 0.754 (95% confidence interval [CI], 0.6326-0.8745) in the training cohort and 0.727 (95% CI, 0.5449-0.9097) in the validation cohort. The specificity and sensitivity were 0.756 and 0.828 in the training cohort and 0.773 and 0.692 in the validation cohort.Data ConclusionT1 CE MR-based radiomics nomogram serves as a noninvasive biomarker in the prediction of LVSI in patients with cervical cancer preoperatively.Level Of Evidence4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1420-1426.© 2018 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

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