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Radiomics systematic review in cervical cancer: gynecological oncologists’ perspective
  1. Nicolò Bizzarri1,
  2. Luca Russo2,
  3. Miriam Dolciami2,
  4. Konstantinos Zormpas-Petridis2,
  5. Luca Boldrini2,
  6. Denis Querleu1,
  7. Gabriella Ferrandina1,3,
  8. Luigi Pedone Anchora1,
  9. Benedetta Gui2,
  10. Evis Sala2,3 and
  11. Giovanni Scambia1,3
  1. 1UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  2. 2Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  3. 3Università Cattolica del Sacro Cuore, Rome, Italy
  1. Correspondence to Dr Nicolò Bizzarri, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma 00168, Italy; nicolo.bizzarri{at}yahoo.com

Abstract

Objective Radiomics is the process of extracting quantitative features from radiological images, and represents a relatively new field in gynecological cancers. Cervical cancer has been the most studied gynecological tumor for what concerns radiomics analysis. The aim of this study was to report on the clinical applications of radiomics combined and/or compared with clinical-pathological variables in patients with cervical cancer.

Methods A systematic review of the literature from inception to February 2023 was performed, including studies on cervical cancer analysing a predictive/prognostic radiomics model, which was combined and/or compared with a radiological or a clinical-pathological model.

Results A total of 57 of 334 (17.1%) screened studies met inclusion criteria. The majority of studies used magnetic resonance imaging (MRI), but positron emission tomography (PET)/computed tomography (CT) scan, CT scan, and ultrasound scan also underwent radiomics analysis. In apparent early-stage disease, the majority of studies (16/27, 59.3%) analysed the role of radiomics signature in predicting lymph node metastasis; six (22.2%) investigated the prediction of radiomics to detect lymphovascular space involvement, one (3.7%) investigated depth of stromal infiltration, and one investigated (3.7%) parametrial infiltration. Survival prediction was evaluated both in early-stage and locally advanced settings. No study focused on the application of radiomics in metastatic or recurrent disease.

Conclusion Radiomics signatures were predictive of pathological and oncological outcomes, particularly if combined with clinical variables. These may be integrated in a model using different clinical-pathological and translational characteristics, with the aim to tailor and personalize the treatment of each patient with cervical cancer.

  • Cervical Cancer
  • Cervix Uteri
  • Lymphatic Metastasis

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • NB and LR contributed equally.

  • Contributors Conceptualization: GS, NB. Methodology: NB, LR, MD. Data curation: NB, LR, MD, KZP, LB, DQ, GF, LPA, BG, ES. Writing- Original draft preparation: NB, LR, ES, GS. Supervision: ES, GS. Writing- Reviewing and Editing: all authors. Guarantor: NB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.