Radiomics Nomogram Based on Multiple-Sequence Magnetic Resonance Imaging Predicts Long-Term Survival in Patients Diagnosed With Nasopharyngeal Carcinoma

Abstract

PurposeAlthough the tumor–node–metastasis staging system is widely used for survival analysis of nasopharyngeal carcinoma (NPC), tumor heterogeneity limits its utility. In this study, we aimed to develop and validate a radiomics model, based on multiple-sequence magnetic resonance imaging (MRI), to estimate the probability of overall survival in patients diagnosed with NPC.MethodsMultiple-sequence MRIs, including T1-weighted, T1 contrast, and T2-weighted imaging, were collected from patients diagnosed with NPC. Radiomics features were extracted from the contoured gross tumor volume of three sequences from each patient using the least absolute shrinkage and selection operator with the Cox regression model. The optimal Rad score was determined using 12 of the 851 radiomics features derived from the multiple-sequence MRI and its discrimination power was compared in the training and validation cohorts. For better prediction performance, an optimal nomogram (radiomics nomogram-MS) that incorporated the optimal Rad score and clinical risk factors was developed, and a calibration curve and a decision curve were used to further evaluate the optimized discrimination power.ResultsA total of 504 patients diagnosed with NPC were included in this study. The optimal Rad score was significantly correlated with overall survival in both the training [C-index: 0.731, 95% confidence interval (CI): 0.709–0.753] and validation cohorts (C-index: 0.807, 95% CI: 0.782–0.832). Compared with the nomogram developed with only single-sequence MRI, the radiomics nomogram-MS had a higher discrimination power in both the training (C-index: 0.827, 95% CI: 0.809–0.845) and validation cohorts (C-index: 0.836, 95% CI: 0.815–0.857). Analysis of the calibration and decision curves confirmed the effectiveness and utility of the optimal radiomics nomogram-MS.ConclusionsThe radiomics nomogram model that incorporates multiple-sequence MRI and clinical factors may be a useful tool for the early assessment of the long-term prognosis of patients diagnosed with NPC.

Pretreatment multiparametric MRI radiomics-integrated clinical hematological biomarkers can predict early rapid metastasis in patients with nasopharyngeal carcinoma

“…Greater tumor heterogeneity is closely connected with poorer prognosis, which could be only associated with intrinsic aggressive biology or therapy resistance [ 39 ]. We extracted radiomics features from four sequences to construct a prognostic model that may be more comprehensive considering the characteristics of different MRI sequences and exhibited excellent performance for individual prediction [ 40 ]. Wang et al reported that the radiomics model derived from multiple MR sequences had better predictive capability than that derived from a single MR sequence ( p < 0.05) [ 41 ].…”

Deciphering the Prognostic Efficacy of MRI Radiomics in Nasopharyngeal Carcinoma: A Comprehensive Meta-Analysis

“…The allocation of articles from each database and the refinement process to identify relevant studies are detailed in Table S2. After comprehensive analysis, 15 studies were included in our meta-analysis [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35], with the exclusion rationale documented in Table S3 [8,10,34,.…”