Preoperative prediction of lymph node metastasis in endometrial cancer based on an intra- and peritumoral multiparameter MRI radiomics nomogram

Motivation: Whether lymph node metastasis (LNM) affects surgical management in endometrial cancer (EC) patients. Goal(s): To develop and validate a nomogram based on intra- and peritumoral radiomics features and multiparameter MRI imaging features to preoperatively predict LNM in EC. Approach: Three hundred and seventy-four women with histologically confirmed EC were divided into training (n = 220), test (n = 94), and external-validation cohorts (n = 60). Radiomics features were extracted from intra- and peritumoral regions based on axial T2WI and ADC mapping. Results: The nomogram combining the Radscore, CA125, and TAR showed good diagnostic performance (AUCtraining = 0.878, AUCtest = 0.877, AUCexternal-validation = 0.864). Impact: The combined intra- and peritumoral region multiparameter MRI radiomics nomogram could be used to preoperatively predict LNM in EC. Moreover, different field strength data were proportionally mixed for modeling and external validation, expanding the real-world application scenarios of prediction models.