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On the potential use of dynamic contrast-enhanced (DCE) MRI parameters as radiomics features of cervical cancer.

PURPOSE
To evaluate whether the analysis of high-temporal resolution DCE-MRI by various tracer kinetic models could yield useful radiomic features in discriminating cervix carcinoma and normal cervix tissue.


METHODS
Forty-three patients (median age 51 years; range 26-78 years) diagnosed with cervical cancer based on postoperative pathology were enrolled in this study with informed consent. DCE-MRI data with temporal resolution of 2s were acquired and analyzed using the Tofts (TOFTS), extended Tofts (EXTOFTS), conventional two-compartment (CC), adiabatic tissue homogeneity (ATH), and distributed parameter (DP) models. Ability of all kinetic parameters in distinguishing tumor from normal tissue were assessed using Mann-Whitney U test and receiver operating characteristic (ROC) curves. Repeatability of parameter estimates due to sampling of arterial-input functions (AIFs) was also studied using intra-class correlation (ICC) analysis.


RESULTS
Fractional extravascular, extracellular volume (Ve) of all models were significantly smaller in cervix carcinoma than normal cervix tissue, and were associated with large values of area under ROC curve (AUC 0.884 - 0.961). Capillary permeability PS derived from the ATH, CC and DP models also yielded large AUC values (0.730, 0.860 and 0.797). Transfer constant Ktrans derived from TOFTS and EXTOFTS models yielded with smaller AUC (0.587 and 0.701). Repeatability of parameters derived from all models were robust to AIF sampling, with ICC coefficients typically larger than 0.80.


CONCLUSIONS
With the use of high-temporal resolution DCE-MRI, all tracer kinetic models could reflect pathophysiological differences between cervix carcinoma and normal tissue (with significant differences in Ve and PS) and potentially yield radiomic features with diagnostic value.