Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification

Abstract Objectives This study aimed to develop and validate a clinical-radiomics deep learning (DL) model based on MRI for endometrial cancer (EC) molecular subtypes classification. Methods This multicenter retrospective study included EC patients undergoing surgery, MRI, and molecular pathology di...

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Main Authors: Wenyi Yue, Ruxue Han, Haijie Wang, Xiaoyun Liang, He Zhang, Hua Li, Qi Yang
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-025-01966-y
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author Wenyi Yue
Ruxue Han
Haijie Wang
Xiaoyun Liang
He Zhang
Hua Li
Qi Yang
author_facet Wenyi Yue
Ruxue Han
Haijie Wang
Xiaoyun Liang
He Zhang
Hua Li
Qi Yang
author_sort Wenyi Yue
collection DOAJ
description Abstract Objectives This study aimed to develop and validate a clinical-radiomics deep learning (DL) model based on MRI for endometrial cancer (EC) molecular subtypes classification. Methods This multicenter retrospective study included EC patients undergoing surgery, MRI, and molecular pathology diagnosis across three institutions from January 2020 to March 2024. Patients were divided into training, internal, and external validation cohorts. A total of 386 handcrafted radiomics features were extracted from each MR sequence, and MoCo-v2 was employed for contrastive self-supervised learning to extract 2048 DL features per patient. Feature selection integrated selected features into 12 machine learning methods. Model performance was evaluated with the AUC. Results A total of 526 patients were included (mean age, 55.01 ± 11.07). The radiomics model and clinical model demonstrated comparable performance across the internal and external validation cohorts, with macro-average AUCs of 0.70 vs 0.69 and 0.70 vs 0.67 (p = 0.51), respectively. The radiomics DL model, compared to the radiomics model, improved AUCs for POLEmut (0.68 vs 0.79), NSMP (0.71 vs 0.74), and p53abn (0.76 vs 0.78) in the internal validation (p = 0.08). The clinical-radiomics DL Model outperformed both the clinical model and radiomics DL model (macro-average AUC = 0.79 vs 0.69 and 0.73, in the internal validation [p = 0.02], 0.74 vs 0.67 and 0.69 in the external validation [p = 0.04]). Conclusions The clinical-radiomics DL model based on MRI effectively distinguished EC molecular subtypes and demonstrated strong potential, with robust validation across multiple centers. Future research should explore larger datasets to further uncover DL’s potential. Critical relevance statement Our clinical-radiomics DL model based on MRI has the potential to distinguish EC molecular subtypes. This insight aids in guiding clinicians in tailoring individualized treatments for EC patients. Key Points Accurate classification of EC molecular subtypes is crucial for prognostic risk assessment. The clinical-radiomics DL model outperformed both the clinical model and the radiomics DL model. The MRI features exhibited better diagnostic performance for POLEmut and p53abn. Graphical Abstract
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spelling doaj-art-d79b3190e4bd4fa5a91674493b4184d52025-08-20T02:32:04ZengSpringerOpenInsights into Imaging1869-41012025-05-0116111310.1186/s13244-025-01966-yDevelopment and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classificationWenyi Yue0Ruxue Han1Haijie Wang2Xiaoyun Liang3He Zhang4Hua Li5Qi Yang6Department of Radiology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical UniversityInstitute of Research and Clinical Innovations, Neusoft Medical Systems Co., LtdInstitute of Research and Clinical Innovations, Neusoft Medical Systems Co., LtdDepartment of Radiology, Obstetrics and Gynecology Hospital, Fudan UniversityDepartment of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Radiology, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Objectives This study aimed to develop and validate a clinical-radiomics deep learning (DL) model based on MRI for endometrial cancer (EC) molecular subtypes classification. Methods This multicenter retrospective study included EC patients undergoing surgery, MRI, and molecular pathology diagnosis across three institutions from January 2020 to March 2024. Patients were divided into training, internal, and external validation cohorts. A total of 386 handcrafted radiomics features were extracted from each MR sequence, and MoCo-v2 was employed for contrastive self-supervised learning to extract 2048 DL features per patient. Feature selection integrated selected features into 12 machine learning methods. Model performance was evaluated with the AUC. Results A total of 526 patients were included (mean age, 55.01 ± 11.07). The radiomics model and clinical model demonstrated comparable performance across the internal and external validation cohorts, with macro-average AUCs of 0.70 vs 0.69 and 0.70 vs 0.67 (p = 0.51), respectively. The radiomics DL model, compared to the radiomics model, improved AUCs for POLEmut (0.68 vs 0.79), NSMP (0.71 vs 0.74), and p53abn (0.76 vs 0.78) in the internal validation (p = 0.08). The clinical-radiomics DL Model outperformed both the clinical model and radiomics DL model (macro-average AUC = 0.79 vs 0.69 and 0.73, in the internal validation [p = 0.02], 0.74 vs 0.67 and 0.69 in the external validation [p = 0.04]). Conclusions The clinical-radiomics DL model based on MRI effectively distinguished EC molecular subtypes and demonstrated strong potential, with robust validation across multiple centers. Future research should explore larger datasets to further uncover DL’s potential. Critical relevance statement Our clinical-radiomics DL model based on MRI has the potential to distinguish EC molecular subtypes. This insight aids in guiding clinicians in tailoring individualized treatments for EC patients. Key Points Accurate classification of EC molecular subtypes is crucial for prognostic risk assessment. The clinical-radiomics DL model outperformed both the clinical model and the radiomics DL model. The MRI features exhibited better diagnostic performance for POLEmut and p53abn. Graphical Abstracthttps://doi.org/10.1186/s13244-025-01966-yEndometrial cancerMolecular subtypesRadiomicsDeep learningMagnetic resonance imaging
spellingShingle Wenyi Yue
Ruxue Han
Haijie Wang
Xiaoyun Liang
He Zhang
Hua Li
Qi Yang
Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
Insights into Imaging
Endometrial cancer
Molecular subtypes
Radiomics
Deep learning
Magnetic resonance imaging
title Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
title_full Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
title_fullStr Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
title_full_unstemmed Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
title_short Development and validation of clinical-radiomics deep learning model based on MRI for endometrial cancer molecular subtypes classification
title_sort development and validation of clinical radiomics deep learning model based on mri for endometrial cancer molecular subtypes classification
topic Endometrial cancer
Molecular subtypes
Radiomics
Deep learning
Magnetic resonance imaging
url https://doi.org/10.1186/s13244-025-01966-y
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