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Clinical Article
The performance of pretreatment MRI based nomogram in neoadjuvant chemotherapy response prediction in nasopharyngeal carcinoma: A primary study
ZHENG Dechun  XU Shugui  LAI Guojing  CHEN Jiayou  REN Wang  CHEN Yunbin 

Cite this article as: Zheng DC, Xu SG, Lai GJ, et al. The performance of pretreatment MRI based nomogram in neoadjuvant chemotherapy response prediction in nasopharyngeal carcinoma: A primary study[J]. Chin J Magn Reson Imaging, 2021, 12(4): 23-29. DOI:10.12015/issn.1674-8034.2021.04.005.


[Abstract] Objective To investigate a pretreatment MRI based nomogram in predicting neoadjuvant chemotherapy (NAC) response in nasopharyngeal carcinoma (NPC). Materials andMethods Totally 191 patients with NPC were retrospectively enrolled. The volume of interest of every primary nasopharyngeal tumor was contoured on T2WI_FS and T1WI_CE by two experienced doctors and imaging features were extracted. Age, sex, pathologic type, TNM staging and morphologic size of lesions were collected as clinical factors. maximum relevance minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) were sequentially implied to reduce redundancy of imaging features from T2WI_FS and T1WI_CE before radscore calculation. Afterwards, an MRI based nomograms consolidating imaging features and clinical factors were developed based on multivariate logistic regression respectively. ROC curves analysis was performed to assess and compare the performance of three different models; then calibration curve from Hosmer-Lemeshow test and decision curve were acquired.Results A total of 101 NPC patients was categorized as responders after two NAC cycles treatment. Chi-square test demonstrated that T stage was statistical significance between responder and non-responder group (P=0.046). Both the overall performance of nomogram and radiomics model to distinguish responder from non-responders group were moderate. The AUC of nomogram and radiomics model stood at 0.72 [95% CI: 0.63—0.81] for training cohort. And the corresponding AUC in validate cohort were 0.72 (95% CI: 0.59—0.85) and 0.77 (95% CI: 0.74—0.89) for nomogram and radiomics respectively. The accuracy of nomogram for NAC response assessment in NPC was higher than clinics model (0.687 vs. 0.604). It was also suggested mild improvement in nomogram compared to radiomics (0.687 vs. 0.679).Conclusions Pretreatment MRI based nomogram could predict NAC response in NPC, its accuracy was better than clinics model.
[Keywords] nasopharyngeal neoplasms;radiomics;magnetic resonance imaging;neoadjuvant chemotherapy;therapy response

ZHENG Dechun1*   XU Shugui1   LAI Guojing2   CHEN Jiayou1   REN Wang1   CHEN Yunbin1  

1 Department of Radiology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China

2 Department of Radiation Therapy Center, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China

Zheng DC, E-mail: Dechun.zheng@139.com

Conflicts of interest   None.

This work was part of Natural Science Foundation of Fujian Province (No. 2017J01180); Science and Technology Program of Fujian Province (No. 2018Y2003) and Scholarship for Studying Abroad in Fujian Province.
Received  2020-07-22
Accepted  2021-01-12
DOI: 10.12015/issn.1674-8034.2021.04.005
Cite this article as: Zheng DC, Xu SG, Lai GJ, et al. The performance of pretreatment MRI based nomogram in neoadjuvant chemotherapy response prediction in nasopharyngeal carcinoma: A primary study[J]. Chin J Magn Reson Imaging, 2021, 12(4): 23-29. DOI:10.12015/issn.1674-8034.2021.04.005.

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