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MRI-based radiomics nomogram for predicting temporal lobe injury after radiotherapy in nasopharyngeal carcinoma

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Abstract

Objectives

To develop and validate a magnetic resonance imaging (MRI)–based radiomics nomogram model combining radiomic features and clinical factors for the prediction of radiotherapy-induced temporal lobe injury (RTLI) in patients with nasopharyngeal carcinoma (NPC).

Methods

From 203 NPC cases receiving radiotherapy, 128 RTLI-positive and 278 RTLI-negative lobes were retrospectively analyzed. They were randomly divided into training (n = 285) and validation (n = 121) sets. Three hundred ninety-six texture features based on T2WI images were extracted from each temporal lobe. The minimum redundancy maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) were used to reduce the dimension of the features and establish a radiomics signature model. Clinical risk factors and the radiomics signature were combined by multivariable logistic regression analysis to construct a radiomics nomogram model. We assessed the performance of the radiomics nomogram on discrimination, calibration, and clinical utility.

Results

The radiomics signature consisted of 14 selected features that were significantly associated with RTLI. In the training set, the radiomics nomogram model demonstrated a better predictive performance (AUC, 0.87; 95% CI, 0.82–0.91) than the radiomics model (AUC, 0.71; 95% CI, 0.65–0.78) and clinical model (AUC, 0.73; 95% CI, 0.67–0.79). These results were confirmed in the validation set. The radiomics nomogram model demonstrated good calibration and was clinically useful by decision curve analysis.

Conclusion

The radiomics nomogram model combining radiomics signatures and clinical factors is an effective method for the noninvasive prediction of RTLI in NPC patients after radiotherapy.

Key Points

• The radiomics model based on T2WI images at the end of intensity-modulated radiotherapy can predict radiotherapy-induced temporal lobe injury in patients with NPC.

• Dosimetric factors can improve the prediction performance of the radiomics model in predicting radiotherapy-induced temporal lobe injury.

• An MRI-based radiomics nomogram combining radiomics signatures and clinical factors had better prediction performance than both radiomics and clinical model for the prediction of radiotherapy-induced temporal lobe injury in patients with NPC.

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Abbreviations

D max :

Maximum dose

D mean :

Mean dose

D min :

Minimum dose

IMRT:

Intensity-modulated radiotherapy

NPC:

Nasopharyngeal carcinoma

RTLI:

Radiotherapy-induced temporal lobe injury

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Funding

This study was supported by the Provincial Technology Innovation Guidance Plan-Clinical Medical Technology Innovation Guidance Project (Project no. 2017SK50601).

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, People’s Republic of China

    Jing Hou, Handong Li, Zhaodong Ai, Feiping Li, Qiang Lu & Xiaoping Yu

  2. Department of Radiotherapy, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, People’s Republic of China

    Biao Zeng

  3. Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China

    Peipei Pang

Authors
  1. Jing Hou
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  2. Handong Li
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  3. Biao Zeng
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  4. Peipei Pang
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  5. Zhaodong Ai
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  6. Feiping Li
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  7. Qiang Lu
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  8. Xiaoping Yu
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Corresponding author

Correspondence to Xiaoping Yu.

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The scientific guarantor of this publication is Xiaoping Yu.

Conflict of Interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and Biometry

One of the authors has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Hou, J., Li, H., Zeng, B. et al. MRI-based radiomics nomogram for predicting temporal lobe injury after radiotherapy in nasopharyngeal carcinoma. Eur Radiol 32, 1106–1114 (2022). https://doi.org/10.1007/s00330-021-08254-5

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