Prediction of outcome using pretreatment 18F-FDG PET/CT and MRI radiomics in locally advanced cervical cancer treated with chemoradiotherapy

  • François LuciaEmail author
  • Dimitris Visvikis
  • Marie-Charlotte Desseroit
  • Omar Miranda
  • Jean-Pierre Malhaire
  • Philippe Robin
  • Olivier Pradier
  • Mathieu Hatt
  • Ulrike Schick
Original Article



The aim of this study is to determine if radiomics features from 18fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) images could contribute to prognoses in cervical cancer.


One hundred and two patients (69 for training and 33 for testing) with locally advanced cervical cancer (LACC) receiving chemoradiotherapy (CRT) from 08/2010 to 12/2016 were enrolled in this study. 18F-FDG PET/CT and MRI examination [T1, T2, T1C, diffusion-weighted imaging (DWI)] were performed for each patient before CRT. Primary tumor volumes were delineated with the fuzzy locally adaptive Bayesian algorithm in the PET images and with 3D Slicer™ in the MRI images. Radiomics features (intensity, shape, and texture) were extracted and their prognostic value was compared with clinical parameters for recurrence-free and locoregional control.


In the training cohort, median follow-up was 3.0 years (range, 0.43–6.56 years) and relapse occurred in 36% of patients. In univariate analysis, FIGO stage (I–II vs. III–IV) and metabolic response (complete vs. non-complete) were probably associated with outcome without reaching statistical significance, contrary to several radiomics features from both PET and MRI sequences. Multivariate analysis in training test identified Grey Level Non UniformityGLRLM in PET and EntropyGLCM in ADC maps from DWI MRI as independent prognostic factors. These had significantly higher prognostic power than clinical parameters, as evaluated in the testing cohort with accuracy of 94% for predicting recurrence and 100% for predicting lack of loco-regional control (versus ~50–60% for clinical parameters).


In LACC treated with CRT, radiomics features such as EntropyGLCM and GLNUGLRLM from functional imaging DWI-MRI and PET, respectively, are independent predictors of recurrence and loco-regional control with significantly higher prognostic power than usual clinical parameters. Further research is warranted for their validation, which may justify more aggressive treatment in patients identified with high probability of recurrence.


Chemoradiotherapy Cervical cancer Radiomics Prediction FDG PET MRI 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

259_2017_3898_MOESM1_ESM.docx (5.5 mb)
ESM 1 (DOCX 5659 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • François Lucia
    • 1
    • 2
    Email author
  • Dimitris Visvikis
    • 3
  • Marie-Charlotte Desseroit
    • 3
  • Omar Miranda
    • 1
  • Jean-Pierre Malhaire
    • 1
  • Philippe Robin
    • 4
  • Olivier Pradier
    • 1
    • 3
  • Mathieu Hatt
    • 3
  • Ulrike Schick
    • 1
    • 3
  1. 1.Radiation Oncology DepartmentUniversity HospitalBrestFrance
  2. 2.Service de RadiothérapieCHRU MorvanCedexFrance
  3. 3.LaTIM, INSERM, UMR 1101University of Brest, ISBAM, UBO, UBLBrestFrance
  4. 4.Nuclear Medicine DepartmentUniversity HospitalBrestFrance

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