Abstract
BACKGROUND: To identify predictive value of apparent diffusion coefficient (ADC) values and magnetic resonance imaging (MRI)-based radiomics for all recurrences in patients with endometrial carcinoma (EC). METHODS: One hundred and seventy-four EC patients who were treated with operation and followed up in our institution were retrospectively reviewed, and the patients were divided into training and test group. Baseline clinicopathological features and mean ADC (ADC(mean)), minimum ADC (ADC(min)), and maximum ADC (ADC(max)) were analyzed. Radiomic parameters were extracted on T2 weighted images and screened by logistic regression, and then a radiomics signature was developed to calculate the radiomic score (radscore). In training group, Kaplan-Meier analysis was performed and a Cox regression model was used to evaluate the correlation between clinicopathological features, ADC values and radscore with recurrence, and verified in the test group. RESULTS: ADC(mean) showed inverse correlation with recurrence, while radscore was positively associated with recurrence. In univariate analyses, FIGO stage, pathological types, myometrial invasion, ADC(mean), ADC(min) and radscore were associated with recurrence. In the training group, multivariate Cox analysis showed that pathological types, ADC(mean) and radscore were independent risk factors for recurrence, which were verified in the test group. CONCLUSIONS: ADC(mean) value and radscore were independent predictors of recurrence of EC, which can supplement prognostic information in addition to clinicopathological information and provide basis for individualized treatment and follow-up plan.