Development of a radiomic-clinical nomogram for prediction of survival in patients with nasal extranodal natural killer T-cell lymphoma

Abstract

Abstract Purpose There is still currently a lack of magnetic resonance imaging (MRI) based radiomics analysis in the prognosis model for patients with nasal extranodal natural killer/T-cell lymphoma (ENKTL). We aim to investigate the value of MRI-based radiomics signature in the prognosis for patients with nasal ENKTL. Methods 159 nasal ENKTL patients were enrolled and divided into a training cohort (n = 81) and a validation cohort (n = 78) randomly. Radiomics features from pretreatment MRI examination were extracted respectively. Then two sample t-test and least absolute shrinkage and selection operator (LASSO) regression were used to select the radiomics signatures and establish the Rad-score. A radiomics nomogram based on the Rad-score and clinical features was constructed to predict overall survival (OS). Results The radiomics model that integrated Rad-score and clinical risk factors exhibited a satisfactory prediction performance compared with the Rad-score and clinical models in terms of OS in the training cohort (C-index: 0.849 vs. 0.733 vs. 0.707, AUC: 0.896 vs. 0.767 vs.0.798). For validation, the C-index of the three models was 0.931 vs. 0.824 vs. 0.635 respectively. Moreover, the AUC was 0.839 vs. 0.827 vs. 0.583 respectively. The calibration curves also suggested that the net benefit of radiomics models was higher than that of the Rad-score and clinical models. Conclusions The Rad-score was significantly correlated with OS for nasal ENKTL patients. Moreover, the MRI-based radiomics nomogram could be used for risk stratification and provide personalized treatment plans for patients.