Abstract
Objectives
To establish and validate a radiomics nomogram for prediction of induction chemotherapy (IC) response and survival in nasopharyngeal carcinoma (NPC) patients.
Methods
One hundred twenty-three NPC patients (100 in training and 23 in validation cohort) with multi-MR images were enrolled. A radiomics nomogram was established by integrating the clinical data and radiomics signature generated by support vector machine.
Results
The radiomics signature consisting of 19 selected features from the joint T1-weighted (T1-WI), T2-weighted (T2-WI), and contrast-enhanced T1-weighted MRI images (T1-C) showed good prognostic performance in terms of evaluating IC response in two cohorts. The radiomics nomogram established by integrating the radiomics signature with clinical data outperformed clinical nomogram alone (C-index in validation cohort, 0.863 vs 0.549; p < 0.01). Decision curve analysis demonstrated the clinical utility of the radiomics nomogram. Survival analysis showed that IC responders had significant better PFS (progression-free survival) than non-responders (3-year PFS 84.81% vs 39.75%, p < 0.001). Low-risk groups defined by radiomics signature had significant better PFS than high-risk groups (3-year PFS 76.24% vs 48.04%, p < 0.05).
Conclusions
Multiparametric MRI-based radiomics could be helpful for personalized risk stratification and treatment in NPC patients receiving IC.
Key Points
• MRI Radiomics can predict IC response and survival in non-endemic NPC.
• Radiomics signature in combination with clinical data showed excellent predictive performance.
• Radiomics signature could separate patients into two groups with different prognosis.
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Abbreviations
- CCRT:
-
Concurrent chemoradiation
- IC:
-
Induction chemotherapy
- IMRT:
-
Intensity-modulated radiotherapy
- LASSO:
-
Least absolute shrinkage and selection operator
- NPC:
-
Nasopharyngeal carcinoma
- PFS:
-
Progression-free survival
- RF:
-
Random forest
- SVM:
-
Support vector machine
- T1-C:
-
T1 contrast
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Funding
This study has received funding by the National Natural Science Foundation of China Grants 81872699 and Key project of Shanxi Province 2017ZDXM-SF-043.
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The scientific guarantor of this publication is Lina Zhao.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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Yutian Yin, one of the authors, has significant statistical expertise.
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Written informed consent was not required for this study because the retrospective nature of the study.
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Institutional Review Board approval was obtained.
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• retrospective
• diagnostic or prognostic study
• performed at one institution
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Zhao, L., Gong, J., Xi, Y. et al. MRI-based radiomics nomogram may predict the response to induction chemotherapy and survival in locally advanced nasopharyngeal carcinoma. Eur Radiol 30, 537–546 (2020). https://doi.org/10.1007/s00330-019-06211-x
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DOI: https://doi.org/10.1007/s00330-019-06211-x