{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:25:02Z","timestamp":1788895502091,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171906"],"award-info":[{"award-number":["82171906"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Residual lymphadenopathy and detectable Epstein\u2013Barr virus (EBV) DNA after radiotherapy (RT) are known negative prognostic factors for nasopharyngeal carcinoma (NPC). However, there is a need to distinguish between patients with residual disease that will metastasize and those who will not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To develop a prognostic model to improve the risk stratification of NPC patients after RT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Three hundred eighty\u2010seven NPC patients treated with RT between January 2010 and January 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>T1\u2010, T2\u2010weighted and enhanced T1\u2010weighted imaging at 1.5 or 3.0\u2009T pretreatment and 3\u20134\u2009months post\u2010RT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Post\u2010RT central nodal necrosis (CNN) and other nodal characteristics on MRI were assessed by three radiologists independently. EBV DNA was measured by quantitative polymerase chain reaction. The association between these variables and the primary endpoint (5\u2010year distant metastasis\u2010free survival [DMFS], time from the day of diagnosis to any distant metastasis) was analyzed. Nomograms A (pre\u2010\/posttreatment EBV\u2010DNA\u2009+\u2009N stage\u2009+\u2009post\u2010RT retropharyngeal lymph node [RLN] CNN), B (tumor\u2010node\u2010metastasis [TNM] stage\u2009+\u2009pretreatment EBV\u2010DNA), and C (TNM stage\u2009+\u2009post\u2010RT EBV\u2010DNA) were developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Univariate and multivariate analyses were performed with the Cox regression model. Nomograms were developed based on the Cox regression model and two prognostic models. The concordance index (C\u2010index) and calibration curve were used to evaluate the discriminative ability of the nomograms and TNM stage. <jats:italic>P<\/jats:italic>\u2010values &lt;\u20090.05 were considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Post\u2010RT RLN CNN was an independent prognostic factor for 5\u2010year DMFS (hazard ratio, 2.88 [1.48\u20135.62]). Nomogram A (C\u2010index 0.728 [0.660\u20130.797]) demonstrated better risk discrimination than nomogram B (0.638 [0.571\u20130.705]), nomogram C (0.707 [0.636\u20130.778]), and the TNM stage (0.587 [0.515\u20130.659]) for 5\u2010year DMFS in NPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Nomogram A combining pretreatment EBV\u2010DNA and N stage with post\u2010RT EBV\u2010DNA and RLN CNN improved the prognostic risk stratification for DMFS in NPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>4<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28515","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T12:03:55Z","timestamp":1667477035000},"page":"108-119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Integrating Postradiotherapy <scp>MRI<\/scp>\u2010Detected Lymph Node Necrosis and Pre\u2010 and Posttreatment Epstein\u2013Barr <scp>Virus\u2010DNA<\/scp> for Risk Stratification in Nasopharyngeal Carcinoma"],"prefix":"10.1002","volume":"58","author":[{"given":"Di","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaolong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5854-3989","authenticated-orcid":false,"given":"Haojiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3977-0518","authenticated-orcid":false,"given":"Lizhi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"},{"name":"Department of Radiology The Third People's Hospital of Shenzhen  Shenzhen People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)  Haikou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-3419","authenticated-orcid":false,"given":"Tingting","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70320-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.06.013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00055-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890060036007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.10.2607"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.07.062"},{"issue":"24","key":"e_1_2_8_9_1","first-page":"6878","article-title":"Molecular prognostication of nasopharyngeal carcinoma by quantitative analysis of circulating Epstein\u2010Barr virus DNA","volume":"60","author":"Lo YM","year":"2000","journal-title":"Cancer Res"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/17588359211052417"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31741"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31856"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.21.1614"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032260"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.77.7847"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06537-6"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.523956"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06155-2"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.12.018"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.17957"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1992.01880090039012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.01.021"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27515"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.177.2.2217772"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23555"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.10.020"},{"issue":"6","key":"e_1_2_8_27_1","first-page":"4059","article-title":"Comparison of Epstein\u2010Barr virus DNA level in plasma, peripheral blood cell and tumor tissue in nasopharyngeal carcinoma","volume":"24","author":"Shao JY","year":"2004","journal-title":"Anticancer Res"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv291"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.03.289"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.03.017"},{"issue":"11","key":"e_1_2_8_31_1","first-page":"4532","article-title":"Comparison of MRI, CT and 18F\u2010FDG PET\/CT in the diagnosis of local and metastatic of nasopharyngeal carcinomas: An updated meta analysis of clinical studies","volume":"8","author":"Chen WS","year":"2016","journal-title":"Am J Transl Res"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40880-019-0357-9"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.17998"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.11.011"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/07357907.2016.1245317"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu117"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40880-018-0286-z"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2272011747"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0344-0338(11)81075-7"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.28515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmri.28515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.28515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T09:27:55Z","timestamp":1692523675000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.28515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,3]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/jmri.28515"],"URL":"https:\/\/doi.org\/10.1002\/jmri.28515","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,3]]},"assertion":[{"value":"2022-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}