Objective To determine whether the measurement of three-dimensional morphological parameters based on magnetic resonance imaging (MRI) can accurately predict the T-stage diagnosis of cervical cancer (CC) tumors or not after three-dimensional reconstruction. Methods Preoperative MRI images from 108 patients with pathologically confirmed cervical cancer were retrospectively collected and divided into four groups: T1, T2, T3 and T4. T1 and T2 were further divided into four subgroups: T1a, T1b, T2a and T2b. The Amira2019 software was used to segment and 3D reconstruct the tumor, uterus, vagina, bladder, urethra, and rectum. The surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter, roughness, texture uniformity and degree of vaginal invasion of tumor were measured. The statistical differences were evaluated by using Kruskal-Wallis test, [χ2]-test, receiver operating characteristic (ROC) curve, etc., and the cut-off values for different T-stages were calculated based on Youden's index. Results There were statistical differences in the surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter and degree of vaginal invasion of tumor between T1-T4 and T1a-T2b (P<0.05), while there was no statistical difference in roughness and texture uniformity between T1-T4 and T1a-T2b (P<0.001). Among them, the longitudinal average diameters of T1-T4 tumors were 2.82 cm, 3.78 cm, 4.82 cm and 6.61 cm (P<0.001), respectively, with cut-off values of 3.17 cm , 4.24 cm and 6.57 cm (AUC=0.699, 0.73, 0.708). The longitudinal average diameters of T1a-T2b tumors were 2.31 cm, 2.84 cm, 3.63 cm and 4.09 cm (P=0.008), respectively, with cut-off values of 2.32 cm, 3.12 cm and 3.94 cm (AUC=0.597, 0.689, 0.561). Conclusions The morphological parameters of cervical cancer tumors on MRI include surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter, and degree of vaginal invasion of tumor, which are valuable diagnostic factors for predicting T-stage in cervical cancer patients. This study contributes to the accurate diagnosis, prognostic evaluation, and treatment decision-making of cervical cancer.
Key words
Cervical cancer; /
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Magnetic resonance imaging (MRI); /
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T-stage diagnosis; /
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Three-dimensional reconstruction
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