Advanced nasopharyngeal carcinoma: pre-treatment prediction of progression based on multi-parametric MRI radiomics

We aimed to investigate the potential of radiomic features of magnetic resonance imaging (MRI) to predict progression in patients with advanced nasopharyngeal carcinoma (NPC). One hundred and thirteen consecutive patients (01/2007-07/2013) (training cohort: n = 80; validation cohort: n = 33) with advanced NPC were enrolled. A total of 970 initial features were extracted from T2-weighted (T2-w) (n = 485) and contrast-enhanced T1-weighted (CET1-w) MRI (n = 485) for each patient. We used least absolute shrinkage and selection operator (Lasso) method to select features that were most significantly associated with the progression. The selected features were used to construct radiomics-based models and the predictive performance of which were assessed with respect to the area under the curve (AUC). As a result, eight features significantly associated with the progression of advanced NPC were identified. In the training cohort, a radiomic model based on combined CET1-w and T2-w images (AUC: 0.886, 95%CI: 0.815-0.956) demonstrated better prognostic performance than models based on CET1-w (AUC: 0.793, 95%CI: 0.698-0.889) or T2-w images alone (AUC: 0.813, 95%CI: 0.721-0.904). These results were confirmed in the validation cohort. Accordingly, MRI-based radiomic biomarkers present high accuracy in the pre-treatment prediction of progression in advanced NPC.