Machine Learning-Based Prognostic Modelling Using MRI Radiomic Data in Cervical Cancer Treated with Definitive Chemoradiotherapy and Brachytherapy.

backgroundThis study aims to evaluate the contribution of clinical and radiomic features to machine learning-based models for survival prediction in patients with locally advanced cervical cancer.

methodsClinical and radiomic data from 161 patients were retrospectively collected from a single center. Radiomic features were obtained from contrast-enhanced magnetic resonance imaging (MRI) T1-weighted (T1W), T2-weighted (T2W), and diffusion-weighted (DWI) sequences. After data cleaning, feature engineering, and scaling, survival prediction models were created using the CatBoost algorithm with different data combinations (clinical, clinical + T1W, clinical + T2W, clinical + DWI). The performance of the models was evaluated using test accuracy, precision, recall, F1-score, ROC curve, and Bland-Altman analysis.

resultsModels using both clinical and radiomic features showed significant improvements in accuracy and F1-score compared to models based solely on clinical data. In particular, the CatBoost_CLI + T2W_DMFS model achieved the best performance, with a test accuracy of 92.31% and an F1-score of 88.62 for distant metastasis-free survival prediction. ROC and Bland-Altman analyses further demonstrated that this model has high discriminative power and prediction consistency.

conclusionsThe CatBoost algorithm shows high accuracy and reliability for survival prediction in locally advanced cervical cancer when clinical and radiomic features are combined. The addition of radiomics data significantly improves model performance.