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Virarkar M, Daoud T, Sun J, Montanarella M, Menendez-Santos M, Mahmoud H, Saleh M, Bhosale P. MRI Radiomics Data Analysis for Differentiation between Malignant Mixed Müllerian Tumors and Endometrial Carcinoma. Cancers (Basel) 2024; 16:2647. [PMID: 39123375 PMCID: PMC11312193 DOI: 10.3390/cancers16152647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
The objective of this study was to compare the quantitative radiomics data between malignant mixed Müllerian tumors (MMMTs) and endometrial carcinoma (EC) and identify texture features associated with overall survival (OS). This study included 61 patients (36 with EC and 25 with MMMTs) and analyzed various radiomic features and gray-level co-occurrence matrix (GLCM) features. These variables and patient clinicopathologic characteristics were compared between EC and MMMTs using the Wilcoxon Rank sum and Fisher's exact test. The area under the curve of the receiving operating characteristics (AUC ROC) was calculated for univariate analysis in predicting EC status. Logistic regression with elastic net regularization was performed for texture feature selection. This study showed that skewness (p = 0.045) and tumor volume (p = 0.007) significantly differed between EC and MMMTs. The range of cluster shade, the angular variance of cluster shade, and the range of the sum of squares variance were significant predictors of EC status (p ≤ 0.05). The regularized Cox regression analysis identified the "256 Angular Variance of Energy" texture feature as significantly associated with OS independently of the EC/MMMT grouping (p = 0.004). The volume and texture features of the tumor region may help distinguish between EC and MMMTs and predict patient outcomes.
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Affiliation(s)
- Mayur Virarkar
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (M.V.); (M.M.)
| | - Taher Daoud
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.D.); (J.S.); (H.M.); (M.S.); (P.B.)
| | - Jia Sun
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.D.); (J.S.); (H.M.); (M.S.); (P.B.)
| | - Matthew Montanarella
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (M.V.); (M.M.)
| | - Manuel Menendez-Santos
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (M.V.); (M.M.)
| | - Hagar Mahmoud
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.D.); (J.S.); (H.M.); (M.S.); (P.B.)
| | - Mohammed Saleh
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.D.); (J.S.); (H.M.); (M.S.); (P.B.)
| | - Priya Bhosale
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.D.); (J.S.); (H.M.); (M.S.); (P.B.)
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Fan Z, Sun X, Han X, Sun C, Huang D. Exploring the significance of tumor volume in endometrial cancer: Clinical pathological features, prognosis, and adjuvant therapies. Medicine (Baltimore) 2023; 102:e36442. [PMID: 38115321 PMCID: PMC10727535 DOI: 10.1097/md.0000000000036442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023] Open
Abstract
To assist clinicians in formulating treatment strategies for endometrial cancer (EC), this retrospective study explores the relationship between tumor volume and clinical pathological features, as well as prognosis, in patients undergoing staging surgery. Preoperative pelvic MRI examinations were conducted on 234 histologically confirmed EC patients. The ITK-SNAP software was employed to manually delineate the region of interest in the MRI images and calculate the tumor volume (MRI-TV). The analysis focused on investigating the relationship between MRI-TV and the clinical pathological features and prognosis of EC patients. Larger MRI-TV was found to be associated with various adverse prognostic factors (G3, deep myometrial invasion, cervical stromal invasion, lymphovascular space invasion, lymph node metastasis, advanced international federation of gynecology and obstetrics staging, and receipt of adjuvant therapy). The receiver operating characteristic curve indicated that MRI-TV ≥ 8 cm3 predicted deep myometrial invasion, and MRI-TV ≥ 12 cm3 predicted lymph node metastasis. Penalized spline (P-spline) regression analysis identified 14 cm3 of MRI-TV as the optimal prognostic cutoff value. MRI-TV ≥ 14 cm3 was an independent prognostic factor for overall survival and disease-free survival. For patients with MRI-TV ≥ 14 cm3, the disease-free survival rate with adjuvant therapy was superior to that of the sole staging surgery group. This study demonstrates a significant correlation between MRI-TV and clinical pathological features and prognosis in EC. For patients with MRI-TV ≥ 14 cm3, staging surgery followed by adjuvant therapy was superior to sole staging surgery.
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Affiliation(s)
- Zhixiang Fan
- The Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
| | - Xinxin Sun
- The Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
| | - Xiting Han
- The Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
| | - Caiping Sun
- The Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
| | - Dongmei Huang
- The Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
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Hashimoto C, Shigeta S, Shimada M, Shibuya Y, Ishibashi M, Kageyama S, Sato T, Tokunaga H, Takase K, Yaegashi N. Diagnostic Performance of Preoperative Imaging in Endometrial Cancer. Curr Oncol 2023; 30:8233-8244. [PMID: 37754512 PMCID: PMC10527880 DOI: 10.3390/curroncol30090597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Endometrial cancer is one of the most common gynecological malignancies. Because the findings mentioned in radiogram interpretation reports issued by diagnostic radiologists influence treatment strategies, we aimed to evaluate the diagnostic accuracy of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) interpretation results in clinically relevant settings. METHODS The clinical records of patients diagnosed with endometrial cancer treated at Tohoku University Hospital from January 2012 to December 2021 were reviewed. The preoperative and pathologically estimated cancer stages were compared based on the results mentioned in the radiogram interpretation report. RESULTS The preoperative and postoperative cancer stages were concordant in 70.0% of the patients. By contrast, the cancer stage was underdiagnosed and overdiagnosed in 21.7% and 8.2% of the patients, respectively. The sensitivities of MRI for deep myometrial invasion, cervical stromal invasion, vaginal invasion, and adnexal metastasis were 65.1%, 58.2%, 33.3%, and 18.4%, respectively. The sensitivity and specificity for pelvic lymph node metastasis using a combination of CT and MRI were 40.9% and 98.4%, respectively. Those for para-aortic lymph node metastases using CT were 37.0% and 99.5%, respectively. CONCLUSIONS The low sensitivity observed in this study clarified the limitations of preoperative diagnostic performance in current clinical practice.
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Affiliation(s)
- Chiaki Hashimoto
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
| | - Shogo Shigeta
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8573, Japan
| | - Yusuke Shibuya
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
| | - Masumi Ishibashi
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
| | - Sakiko Kageyama
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Tomomi Sato
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.H.)
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