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

Kai Liu; Qingtao Qiu; Yonghui Qin; Ting Chen; Diangang Zhang; Li Huang; Yong Yin; Ruozheng Wang

doi:10.3389/fonc.2022.852348

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

Front Oncol. 2022 Apr 7:12:852348. doi: 10.3389/fonc.2022.852348. eCollection 2022.

Authors

Kai Liu¹, Qingtao Qiu², Yonghui Qin¹, Ting Chen¹, Diangang Zhang¹, Li Huang¹, Yong Yin², Ruozheng Wang¹

Affiliations

¹ Department of Head and Neck Comprehensive Radiotherapy, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
² Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.

Abstract

Purpose: Although 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.

Methods: Multiple-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.

Results: A 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.

Conclusions: The 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.

Keywords: multiple-sequence MRI; nasopharyngeal carcinoma; nomogram; overall survival; prediction model; radiomics.