Machine Learning for Preoperative Assessment and Postoperative Prediction in Cervical Cancer: Multicenter Retrospective Model Integrating MRI and Clinicopathological Data
Bibliographic record
Abstract
Background: Machine learning (ML) has been increasingly applied to cervical cancer (CC) research. However, few studies have combined both clinical parameters and imaging data. At the same time, there remains an urgent need for more robust and accurate preoperative assessment of parametrial invasion and lymph node metastasis, as well as postoperative prognosis prediction. Objective: The objective of this study is to develop an integrated ML model combining clinicopathological variables and magnetic resonance image features for (1) preoperative parametrial invasion and lymph node metastasis detection and (2) postoperative recurrence and survival prediction. Methods: Retrospective data from 250 patients with CC (2014-2022; 2 tertiary hospitals) were analyzed. Variables were assessed for their predictive value regarding parametrial invasion, lymph node metastasis, survival, and recurrence using 7 ML models: K-nearest neighbor (KNN), support vector machine, decision tree, random forest (RF), balanced RF, weighted DT, and weighted KNN. Performance was assessed via 5-fold cross-validation using accuracy, sensitivity, specificity, precision, F1-score, and area under the receiver operating characteristic curve (AUC). The optimal models were deployed in an artificial intelligence-assisted contouring and prognosis prediction system. Results: Among 250 women, there were 11 deaths and 24 recurrences. (1) For preoperative evaluation, the integrated model using balanced RF achieved optimal performance (sensitivity 0.81, specificity 0.85) for parametrial invasion, while weighted KNN achieved the best performance for lymph node metastasis (sensitivity 0.98, AUC 0.72). (2) For postoperative prognosis, weighted KNN also demonstrated high accuracy for recurrence (accuracy 0.94, AUC 0.86) and mortality (accuracy 0.97, AUC 0.77), with relatively balanced sensitivity of 0.80 and 0.33, respectively. (3) An artificial intelligence-assisted contouring and prognosis prediction system was developed to support preoperative evaluation and postoperative prognosis prediction. Conclusions: The integration of clinical data and magnetic resonance images provides enhanced diagnostic capability to preoperatively detect parametrial invasion and lymph node metastasis detection and prognostic capability to predict recurrence and mortality for CC, facilitating personalized, precise treatment strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".