Intra- and peritumoral MRI radiomics assisted in predicting radiochemotherapy response in metastatic cervical lymph nodes of nasopharyngeal cancer

Abstract

Abstract Background: In this investigation, intratumoral (Intra) and peritumoral (Peri) features obtained from MRI imaging were used to create and evaluate radiomic models for response prediction to radiochemotherapy of metastatic cervical lymph nodes in individuals with nasopharyngeal cancer (NPC). Methods: Retrospectively, we included 145 consecutive subjects with NPC, 102 in the training set and 43 in the validation set. A total of 5408 initial radiomic features were acquired from the metastatic cervical lymph node's Intra and Peri areas. Then, employing multivariate logistic regression analysis, the radiomic features were chosen and integrated with clinical characteristics to create predictive models. And at last, these developed prediction models were examined using sensitivity, specificity, accuracy, and the area under the curve (AUC) of receiver operating characteristics. Results: In the training and validation sets, there was no statistically significant variation in the AUC among the Intra radiomic signature, Peri radiomic signature, combined Intra and Peri radiomic signature, and combined Intra and Peri radiomic nomogram (all P > 0.05). With an AUC of 0.941 (0.877-0.978) in the training set and 0.783 (0.631-0.894) in the validation set, the combined Intra and Peri radiomic nomogram enabled good discrimination among the responders and non-responders groups. Conclusions: The early response of metastatic cervical lymph nodes to radiochemotherapy in individuals with NPC may be predicted by pretreatment radiomic models determined by the combined Intra and Peri features from MRI imaging, facilitating therapeutic interventions and clinical decision-making.