MRI texture features differentiate clinicopathological characteristics of cervical carcinoma

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MRI texture features differentiate clinicopathological characteristics of cervical carcinoma Mandi Wang 1 & Jose A. U. Perucho 1 & Ka Yu Tse 2 & Mandy M. Y. Chu 3 & Philip Ip 4 & Elaine Y. P. Lee 1 Received: 24 March 2020 / Accepted: 23 April 2020 # European Society of Radiology 2020

Abstract Objectives To evaluate MRI texture analysis in differentiating clinicopathological characteristics of cervical carcinoma (CC). Methods Patients with newly diagnosed CC who underwent pre-treatment MRI were retrospectively reviewed. Texture analysis was performed using commercial software (TexRAD). Largest single-slice ROIs were manually drawn around the tumour on T2weighted (T2W) images, apparent diffusion coefficient (ADC) maps and contrast-enhanced T1-weighted (T1c) images. Firstorder texture features were calculated and compared among histological subtypes, tumour grades, FIGO stages and nodal status using the Mann-Whitney U test. Feature selection was achieved by elastic net. Selected features from different sequences were used to build the multivariable support vector machine (SVM) models and the performances were assessed by ROC curves and AUC. Results Ninety-five patients with FIGO stage IB~IVB were evaluated. A number of texture features from multiple sequences were significantly different among all the clinicopathological subgroups (p < 0.05). Texture features from different sequences were selected to build the SVM models. The AUCs of SVM models for discriminating histological subtypes, tumour grades, FIGO stages and nodal status were 0.841, 0.850, 0.898 and 0.879, respectively. Conclusions Texture features derived from multiple sequences were helpful in differentiating the clinicopathological signatures of CC. The SVM models with selected features from different sequences offered excellent diagnostic discrimination of the tumour characteristics in CC. Key Points • First-order texture features are able to differentiate clinicopathological signatures of cervical carcinoma. • Combined texture features from different sequences can offer excellent diagnostic discrimination of the tumour characteristics in cervical carcinoma. Keywords Magnetic resonance imaging . Squamous cell carcinoma . Adenocarcinoma . Area under the curve . Entropy

Mandi Wang and Jose A. U. Perucho contributed equally to this work. * Elaine Y. P. Lee [email protected] 1

Present address: Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong

2

Department of Obstetrics & Gynaecology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong

3

Department of Obstetrics & Gynaecology, Queen Mary Hospital, Hong Kong, Hong Kong

4

Department of Pathology, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong

Abbreviations ACA Adenocarcinoma ADC Apparent diffusion coefficient AUC Area under the curve CC Cervical carcinoma DWI Diffusion-weighted imaging MPP Mean of