Integrative multi-region MRI radiomics and clinical nomogram for preoperative lymphovascular invasion prediction in rectal cancer: a multicenter validation
Open Access
- 19 December 2025
- journal article
- research article
- Published by Springer Nature in BMC Medical Imaging
- Vol. 26 (1)
Abstract
Objective: This study aims to construct a nomogram using habitat radiomics, radiomics, and clinical features derived from multiparametric MRI (mpMRI) to improve the accuracy of preoperative prediction of lymphovascular invasion (LVI) status in rectal cancer patients. Methods: Data from 372 pathologically confirmed rectal cancer cases were retrospectively collected from two centers. Data from Center 1 were randomly split in a 7:3 ratio into a training cohort ( n = 201) and an internal validation cohort ( n = 87). Data from Center 2 served as external validation ( n = 84). K-means clustering was used to divide the tumor into three subregions. Radiomics features were extracted from regions of interest and selected, and three machine learning algorithms were employed to construct radiomics models. A nomogram was created by integrating clinical, radiomics, and habitat radiomics features. The model’s predictive accuracy was assessed using AUC metrics, while practical clinical applicability was evaluated via calibration plots and decision curve analysis. SHAP values were employed to measure the contribution of individual radiomic features to predictive outcomes, thereby offering transparent insights for clinical decision-making processes. Results: The nomogram model outperformed other single models in predicting LVI, with AUCs of 0.978, 0.909, and 0.889 in the training, validation, and external test sets, respectively. Compared with the intratumoral model alone, the nomogram model achieved improvements of 20.3%, 14.1%, and 13.8%, respectively. Conclusion: The nomogram model developed in this study significantly improved the accuracy of predicting preoperative lymphovascular invasion status in rectal cancer.Keywords
Funding Information
- Ganzhou Science and Technology Plan Project (2022-ZD1373)
This publication has 32 references indexed in Scilit:
- Utilizing intratumoral and peritumoral ultrasound radiomics for predicting KRAS gene mutation status in rectal cancer patientsJournal of Applied Clinical Medical Physics, 2025
- Can Habitat-Based MRI Radiomics Distinguish Between T2 and T3 Stages in Rectal Cancer?Academic Radiology, 2025
- Integration of Deep Learning and Sub-regional Radiomics Improves the Prediction of Pathological Complete Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer PatientsAcademic Radiology, 2025
- Intratumoral habitat radiomics based on magnetic resonance imaging for preoperative prediction treatment response to neoadjuvant chemotherapy in nasopharyngeal carcinomaJapanese Journal of Radiology, 2024
- Association Analysis Between Intratumoral and Peritumoral MRI Radiomics Features and Overall Survival of Neoadjuvant Therapy in Rectal CancerJournal of Magnetic Resonance Imaging, 2024
- The application of apparent diffusion coefficients derived from intratumoral and peritumoral zones for assessing pathologic prognostic factors in rectal cancerEuropean Radiology, 2022
- How can we combat multicenter variability in MR radiomics? Validation of a correction procedureEuropean Radiology, 2020
- Radiomics: the bridge between medical imaging and personalized medicineNature Reviews Clinical Oncology, 2017
- Microenvironmental regulation of tumor progression and metastasisNature Medicine, 2013
- Influence of tumour micro-environment heterogeneity on therapeutic responseNature, 2013