A comparison of 2D and 3D magnetic resonance imaging-based intratumoral and peritumoral radiomics models for the prognostic prediction of endometrial cancer: a pilot study.

Abstract

Background: Accurate prognostic assessment is vital for the personalized treatment of endometrial cancer (EC). Although radiomics models have demonstrated prognostic potential in EC, the impact of region of interest (ROI) delineation strategies and the clinical significance of peritumoral features remain uncertain. Our study thereby aimed to explore the predictive performance of varying radiomics models for the prediction of LVSI, DMI, and disease stage in EC.

Methods: Patients with 174 histopathology-confirmed EC were retrospectively reviewed. ROIs were manually delineated using the 2D and 3D approach on T2-weighted MRI images. Six radiomics models involving intratumoral (2D_intra and 3D_intra), peritumoral (2D_peri and 3D_peri), and combined models (2D_{intra + peri} and 3D_{intra + peri}) were developed. Models were constructed using the logistic regression method with five-fold cross-validation. Area under the receiver operating characteristic curve (AUC) was assessed, and was compared using the Delong's test.

Results: No significant differences in AUC were observed between the 2D_intra and 3D_intra models, or the 2D_peri and 3D_peri models in all prediction tasks (P > 0.05). Significant difference was observed between the 3D_intra and 3D_peri models for LVSI (0.738 vs. 0.805) and DMI prediction (0.719 vs. 0.804). The 3D_{intra + peri} models demonstrated significantly better predictive performance in all 3 prediction tasks compared to the 3D_intra model in both the training and validation cohorts (P < 0.05).

Conclusions: Comparable predictive performance was observed between the 2D and 3D models. Combined models significantly improved predictive performance, especially with 3D delineation, suggesting that intra- and peritumoral features can provide complementary information for comprehensive prognostication of EC.