Clinical translation of a DWI-radiomics nomogram integrating serum biomarkers for pretreatment staging of cervical cancer

Noninvasive and accurate prediction of clinical staging is crucial for patients with cervical cancer (CC). The aim of our study was to develop a clinical model, a diffusion-weighted imaging (DWI)-based radiomics model, and a combined model for staging prediction. We retrospectively enrolled a total of 234 patients with histopathologically confirmed cervical cancer. The patients were divided into a training set (n = 163) and a testing set (n = 71). Radiomics features were extracted from tumor regions in DWI sequences. Clinical features were obtained through univariate and multivariate regression analyses. The clinical model and the DWI-based radiomics model were constructed using the selected features. A nomogram was also created to combine radiomics elements with clinical factors for predicting early-stage and advanced-stage CC. The area under the curve (AUC) values for the radiomics signature, which included features from the tumor’s region of interest (ROI) based on DWI, were 0.928 in the training set and 0.801 in the testing set. When the nomogram combined clinical data with the radiomics signature, the AUC values improved to 0.949 for the training set and 0.847 for the testing set in predicting staging. The novel nomogram, which integrates clinical factors with radiomics features extracted from DWI sequences, demonstrates good performance in staging CC, assisting clinicians in making informed treatment decisions.