Baseline MRI-based radiomics model assisted predicting disease progression in nasopharyngeal carcinoma patients with complete response after treatment

Background Accurate pretreatment prediction for disease progression of nasopharyngeal carcinoma is key to intensify therapeutic strategies to high-risk individuals. Our aim was to evaluate the value of baseline MRI-based radiomics machine-learning models in predicting the disease progression in nasopharyngeal carcinoma patients who achieved complete response after treatment. Methods In this retrospective study, 171 patients with pathologically confirmed nasopharyngeal carcinoma were included. Using hold-out cross validation scheme (7:3), relevant radiomic features were selected with the least absolute shrinkage and selection operator method based on baseline T2-weighted fat suppression and contrast-enhanced T1-weighted images in the training cohort. After Pearson's correlation analysis of selected radiomic features, multivariate logistic regression analysis was applied to radiomic features and clinical characteristics selection. Logistic regression analysis and support vector machine classifier were utilized to build the predictive model respectively. The predictive accuracy of the model was evaluated by ROC analysis along with sensitivity, specificity and AUC calculated in the validation cohort. Results A prediction model using logistic regression analysis comprising 4 radiomics features (HGLZE_T2H, HGLZE_T1, LDLGLE_T1, and GLNU_T1) and 5 clinical features (histology, T stage, N stage, smoking history, and age) showed the best performance with an AUC of 0.75 in the training cohort (95% CI: 0.66-0.83) and 0.77 in the validation cohort (95% CI: 0.64-0.90). The nine independent impact factors were entered into the nomogram. The calibration curves for probability of 3-year disease progression showed good agreement. The features of this prediction model showed satisfactory clinical utility with decision curve analysis. Conclusions A radiomics model derived from pretreatment MR showed good performance for predicting disease progression in nasopharyngeal carcinoma and may help to improve clinical decision making.