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Early risk-assessment of patients with nasopharyngeal carcinoma: the added prognostic value of MR-based radiomics
Translational Oncology ( IF 5 ) Pub Date : 2021-07-15 , DOI: 10.1016/j.tranon.2021.101180
Min-Jung Kim 1 , Yangsean Choi 1 , Yeoun Eun Sung 2 , Youn Soo Lee 2 , Yeon-Sil Kim 3 , Kook-Jin Ahn 1 , Min-Sik Kim 4
Affiliation  

Objectives

To assess the additive prognostic value of MR-based radiomics in predicting progression-free survival (PFS) in patients with nasopharyngeal carcinoma (NPC)

Methods

Patients newly diagnosed with non-metastatic NPC between June 2006 and October 2019 were retrospectively included and randomly grouped into training and test cohorts (7:3 ratio). Radiomic features (n=213) were extracted from T2-weighted and contrast-enhanced T1-weighted MRI. The patients were staged according to the 8th edition of American Joint Committee on Cancer Staging Manual. The least absolute shrinkage and selection operator was used to select the relevant radiomic features. Univariate and multivariate Cox proportional hazards analyses were conducted for PFS, yielding three different survival models (clinical, stage, and radiomic). The integrated time-dependent area under the curve (iAUC) for PFS was calculated and compared among different combinations of survival models, and the analysis of variance was used to compare the survival models. The prognostic performance of all models was validated using a test set with integrated Brier scores.

Results

This study included 81 patients (training cohort=57; test cohort=24), and the mean PFS was 57.5 ± 43.6 months. In the training cohort, the prognostic performances of survival models improved significantly with the addition of radiomics to the clinical (iAUC, 0.72–0.80; p=0.04), stage (iAUC, 0.70–0.79; p=0.001), and combined models (iAUC, 0.76–0.81; p<0.001). In the test cohort, the radiomics and combined survival models were robustly validated for their ability to predict PFS.

Conclusion

Integration of MR-based radiomic features with clinical and stage variables improved the prediction PFS in patients diagnosed with NPC.



中文翻译:

鼻咽癌患者的早期风险评估:基于 MR 的放射组学的附加预后价值

目标

评估基于 MR 的放射组学在预测鼻咽癌 (NPC) 患者的无进展生存期 (PFS) 中的附加预后价值

方法

回顾性纳入 2006 年 6 月至 2019 年 10 月期间新诊断为非转移性 NPC 的患者,并随机分组到训练和测试队列(比例为 7:3)。从 T2 加权和对比增强的 T1 加权 MRI 中提取放射组学特征 (n=213)。患者按第 8分期美国癌症分期联合委员会手册版本。最小绝对收缩和选择算子用于选择相关的放射组学特征。对 PFS 进行了单变量和多变量 Cox 比例风险分析,产生了三种不同的生存模型(临床、分期和放射组学)。计算并比较不同生存模型组合间PFS的积分时间依赖曲线下面积(iAUC),并采用方差分析比较生存模型。使用具有集成 Brier 分数的测试集验证所有模型的预后性能。

结果

该研究包括 81 名患者(训练队列 = 57;测试队列 = 24),平均 PFS 为 57.5 ± 43.6 个月。在训练队列中,将放射组学添加到临床(iAUC,0.72–0.80;p = 0.04)、分期(iAUC,0.70–0.79;p = 0.001)和组合模型( iAUC,0.76–0.81;p <0.001)。在测试队列中,放射组学和组合生存模型预测 PFS 的能力得到了强有力的验证。

结论

基于 MR 的放射组学特征与临床和分期变量的整合提高了诊断为 NPC 的患者的 PFS 预测。

更新日期:2021-07-15
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