Prognostic model based on magnetic resonance imaging, whole-tumour apparent diffusion coefficient values and HPV genotyping for stage IB-IV cervical cancer patients following chemoradiotherapy

Objectives To develop and validate a prognostic model of integrating whole-tumour apparent diffusion coefficient (ADC) from pretreatment diffusion-weighted (DW) magnetic resonance (MR) imaging with human papillomavirus (HPV) genotyping in predicting the overall survival (OS) and disease-free survival (DFS) for women with stage IB–IV cervical cancer following concurrent chemoradiotherapy (CCRT). Methods We retrospectively analysed three prospectively collected cohorts comprising 300 patients with stage IB–IV cervical cancer treated with CCRT in 2007–2014 and filtered 134 female patients who underwent MR imaging at 3.0 T for final analysis (age, 24–92 years; median, 54 years). Univariate and multivariate Cox regression analyses were used to evaluate the whole-tumour ADC histogram parameters, HPV genotyping and relevant clinical variables in predicting OS and DFS. The dataset was randomly split into training ( n = 88) and testing ( n = 46) datasets for construction and independent bootstrap validation of the models. Results The median follow-up time for surviving patients was 69 months (range, 9–126 months). Non-squamous cell type, ADC 10