Predicting Tumor Progression in Patients with Cervical Cancer Using Computer Tomography Radiomic Features

The objective of this study was to evaluate the effectiveness of utilizing radiomic features from radiation planning computed tomography (CT) scans in predicting tumor progression among patients with cervical cancers. A retrospective analysis was conducted on individuals who underwent radiotherapy for cervical cancer between 2015 and 2020, utilizing an institutional database. Radiomic features, encompassing first-order statistical, morphological, Gray-Level Co-Occurrence Matrix (GLCM), Gray-Level Run Length Matrix (GLRLM), and Gray-Level Dependence Matrix (GLDM) features, were extracted from the primary cervical tumor on the CT scans. The study encompassed 112 CT scans from patients with varying stages of cervical cancer ((FIGO Staging of Cervical Cancer 2018): 24% at stage I, 47% at stage II, 21% at stage III, and 10% at stage IV). Of these, 31% (n = 35/112) exhibited tumor progression. Univariate feature analysis identified three morphological features that displayed statistically significant differences (p < 0.05) between patients with and without progression. Combining these features enabled a classification model to be developed with a mean sensitivity, specificity, accuracy, and AUC of 76.1% (CI 1.5%), 70.4% (CI 4.1%), 73.6% (CI 2.1%), and 0.794 (CI 0.029), respectively, employing nested ten-fold cross-validation. This research highlights the potential of CT radiomic models in predicting post-radiotherapy tumor progression, offering a promising approach for tailoring personalized treatment decisions in cervical cancer.