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• Clinical Article •
Value of synthetic MRI based histogram features combined with short axis in diagnosis of lymph node metastasis in nasopharyngeal carcinoma
WEI Haoran  YANG Fan  LI Xiaolu  YU Xiaoduo  LI Lin  ZHAO Yanfeng  LIN Meng  ZHAO Xinming 

DOI:10.12015/issn.1674-8034.2025.08.009.


[Abstract] Objective To explore the value of synthetic MRI (SyMRI) based histogram analysis combined with short axis in diagnosing cervical lymph nodes metastasis (LNM) of nasopharyngeal carcinoma (NPC).Materials and Methods This study retrospectively analyzed 53 newly diagnosed NPC patients, and 377 cervical lymph nodes (LNs) with a short axis ≥ 4 mm (metastatic LNs: 297, non-metastatic LNs: 80). The nodes were randomly stratified into training (metastatic LNs: 208, non-metastatic LNs: 56) and test groups (metastatic LNs: 89, non-metastatic LNs: 24) at a 7∶3 ratio. Histogram parameters were extracted from T1, T2, and proton density (PD) maps of SyMRI and short axis was recorded for each LN. The areas under the curve (AUCs) of all histogram parameters were compared, and Spearman correlation coefficients (SCCs) between parameters were calculated. Parameters with higher diagnostic efficiency (AUC ≥ 0.617) and lower correlation (SCC < 0.8) were incorporated into logistic regression analysis for model construction. Receiver operating characteristic curve (ROC), area under the curve (AUC) and DeLong test were used to evaluate the performance of SyMRI model, size model and combined model in the diagnosis of cervical LNs. Then the nomogram and calibration curves were constructed.Results The SyMRI model, constructed using the T1-10th percentile, T1-variance, PD-10th percentile, and PD-minimum, achieved AUCs of 0.895 (training group) and 0.903 (test group), which were significantly higher than those of the short-axis model (AUCs: 0.824 and 0.797, respectively; both P < 0.05). The combined model demonstrated the highest diagnostic efficiency, with AUCs of 0.941 (training group) and 0.938 (test group), significantly outperforming both individual models (both P < 0.05).Conclusions SyMRI model based on histogram parameters can effectively differentiate metastatic from non-metastatic LNs, and the diagnostic performance improved further when combined with the short axis of nodes.
[Keywords] nasopharyngeal carcinoma；lymph node metastasis；magnetic resonance imaging；synthetic magnetic resonance imaging；histogram analysis；differential diagnosis

WEI Haoran   YANG Fan   LI Xiaolu   YU Xiaoduo   LI Lin   ZHAO Yanfeng   LIN Meng*   ZHAO Xinming  

Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Corresponding author: LIN M, E-mail: lm152@139.com

Conflicts of interest   None.

Received  2025-01-03
Accepted  2025-07-31
DOI: 10.12015/issn.1674-8034.2025.08.009
DOI:10.12015/issn.1674-8034.2025.08.009.

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