Predicting Tumor Budding Status in Cervical Cancer Using MRI Radiomics: Linking Imaging Biomarkers to Histologic Characteristics

SIMPLE SUMMARY: Tumor budding is a histopathologic characteristic which has led to a growing interest in the prognosis prediction of cancers of various sites. We aimed to evaluate whether imaging biomarkers could predict tumor budding status. Preoperative MRI radiomic features were used as imaging biomarkers. Four machine learning classifiers were applied to build prediction models using a training dataset. Internal validation was performed to validate the built models. As a result, radiomics-based models predicted tumor budding status with a mean area under the receiver operating characteristic value of 0.816 and a mean accuracy of 0.779 in the independent test dataset. Final selected features were mostly from filtered images, implying the importance of filtering methods in radiomics. Preoperative prediction of tumor budding status may help personalize treatment in cervical cancer patients. ABSTRACT: Background: Our previous study demonstrated that tumor budding (TB) status was associated with inferior overall survival in cervical cancer. The purpose of this study is to evaluate whether radiomic features can predict TB status in cervical cancer patients. Methods: Seventy-four patients with cervical cancer who underwent preoperative MRI and radical hysterectomy from 2011 to 2015 at our institution were enrolled. The patients were randomly allocated to the training dataset (n = 48) and test dataset (n = 26). Tumors were segmented on axial gadolinium-enhanced T1- and T2-weighted images. A total of 2074 radiomic features were extracted. Four machine learning classifiers, including logistic regression (LR), random forest (RF), support vector machine (SVM), and neural network (NN), were used. The trained models were validated on the test dataset. Results: Twenty radiomic features were selected; all were features from filtered-images and 85% were texture-related features. The area under the curve values and accuracy of the models by LR, RF, SVM and NN were 0.742 and 0.769, 0.782 and 0.731, 0.849 and 0.885, and 0.891 and 0.731, respectively, in the test dataset. Conclusion: MRI-based radiomic features could predict TB status in patients with cervical cancer.