Intratumoral and peritumoral MRI habitat imaging for differentiating stage IA endometrial cancer from benign endometrial lesions: a multicenter study.

Purpose: The aim of this study was to evaluate the value of different multiparametric MRI-based radiomics models in differentiating stage IA endometrial cancer (EC) from benign endometrial lesions. Methods: This retrospective study included 787 patients with stage IA endometrial cancer (EC) or benign endometrial lesions from four centers. Tumor regions of interest (ROIs) were manually delineated on MRI. Employing Python, the following peritumoral ROIs were automatically generated: 3-mm dilated and eroded peritumoral loops (LDE3), 3-mm eroded peritumoral loops (LE3), and intratumoral regions merged with 3-mm dilated peritumoral loops (RD3) Habitat clustering was performed using K-means and Gaussian Mixture Model (GMM) algorithms. Logistic regression was utilized to identify independent predictors and construct habitat-only and combined (clinical + habitat) models. Performance was evaluated using the area under the curve (AUC). Results: Age (P = 0.002) and vaginal bleeding ( Conclusion: Intratumoral and peritumoral habitat imaging based on multiparametric MRI can non-invasively reveal the microstructural characteristics of stage IA EC. Integrating clinical predictors with habitat models showed good diagnostic performance. The peritumoral habitat model exceeded the intratumoral habitat model.