A Serial MRI-based Deep Learning Model to Predict Survival in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma.

Journal: Radiology. Artificial intelligence
PMID: 39812582

Abstract

Purpose To develop and evaluate a deep learning-based prognostic model for predicting survival in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) using serial MRI before and after induction chemotherapy (IC). Materials and Methods This multicenter retrospective study included 1039 patients with LA-NPC (779 male and 260 female patients; mean age, 44 years ± 11 [SD]) diagnosed between December 2011 and January 2016. A radiomics-clinical prognostic model (model RC) was developed using pre- and post-IC MRI acquisitions and other clinical factors using graph convolutional neural networks. The concordance index (C-index) was used to evaluate model performance in predicting disease-free survival (DFS). The survival benefits of concurrent chemoradiation therapy (CCRT) were analyzed in model-defined risk groups. Results The C-indexes of model RC for predicting DFS were significantly higher than those of TNM staging in the internal (0.79 vs 0.53) and external (0.79 vs 0.62, both < .001) testing cohorts. The 5-year DFS for the model RC-defined low-risk group was significantly better than that of the high-risk group (90.6% vs 58.9%, < .001). In high-risk patients, those who underwent CCRT had a higher 5-year DFS rate than those who did not (58.7% vs 28.6%, = .03). There was no evidence of a difference in 5-year DFS rate in low-risk patients who did or did not undergo CCRT (91.9% vs 81.3%, = .19). Conclusion Serial MRI before and after IC can effectively help predict survival in LA-NPC. The radiomics-clinical prognostic model developed using a graph convolutional network-based deep learning method showed good risk discrimination capabilities and may facilitate risk-adapted therapy. Nasopharyngeal Carcinoma, Deep Learning, Induction Chemotherapy, Serial MRI, MR Imaging, Radiomics, Prognosis, Radiation Therapy/Oncology, Head/Neck © RSNA, 2025.

Authors

  • Jia Kou
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Jun-Yi Peng
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Wen-Bing Lv
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Chen-Fei Wu
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Zi-Hang Chen
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Guan-Qun Zhou
    Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
  • Ya-Qin Wang
    Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
  • Li Lin
    Department of Cardiology, Lishui Central Hospital and the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China.
  • Li-Jun Lu
    From the Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China (J.K., C.F.W., Z.H.C., G.Q.Z., Y.Q.W., L.L., Y.S.); Department of Radiotherapy Center, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China (J.Y.P.); School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China (L.J.L.); and Department of Electronic Engineering, Information School, Yunnan University, Kunming, China (W.B.L.).
  • Ying Sun
    CFAR and I2R, Agency for Science, Technology and Research, Singapore.

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