{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:07:43Z","timestamp":1769630863009,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To investigate the potential value of the pretreatment MRI-based radiomic model in predicting the overall survival (OS) of nasopharyngeal carcinoma (NPC) patients with local residual tumors after intensity-modulated radiotherapy (IMRT).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 218 consecutive nonmetastatic NPC patients with local residual tumors after IMRT [training cohort (n\u2009=\u2009173) and validation cohort (n\u2009=\u200945)] were retrospectively included in this study. Clinical and MRI data were obtained. Univariate Cox regression and the least absolute shrinkage and selection operator (LASSO) were used to select the radiomic features from pretreatment MRI. The clinical, radiomic, and combined models for predicting OS were constructed. The models\u2019 performances were evaluated using Harrell\u2019s concordance index (C-index), calibration curve, and decision curve analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The C-index of the radiomic model was higher than that of the clinical model, with the C-index of 0.788 (95% CI 0.724\u20130.852) versus 0.672 (95% CI 0.599\u20130.745) in the training cohort and 0.753 (95% CI 0.604\u20130.902) versus 0.634 (95% CI 0.593\u20130.675) in the\u00a0validation\u00a0cohort. Calibration curves showed good agreement between the radiomic model-predicted probability of 2- and 3-year OS and the actual observed probability in the training and validation groups. Decision curve analysis showed that the radiomic model had higher clinical usefulness than the clinical model. The discrimination of the combined model improved significantly in the training cohort (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) but not in the validation cohort, with the C-index of 0.834 and 0.734, respectively. The radiomic model divided patients into high- and low-risk groups with a significant difference in OS in both the training and validation cohorts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Pretreatment MRI-based radiomic model may improve OS prediction in NPC patients with local residual tumors after IMRT and may assist in clinical decision-making.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-022-00902-6","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T12:02:55Z","timestamp":1664884975000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Development and validation of an MRI-based radiomic model for predicting overall survival in nasopharyngeal carcinoma patients with local residual tumors after intensity-modulated radiotherapy"],"prefix":"10.1186","volume":"22","author":[{"given":"Shengping","family":"Jiang","sequence":"first","affiliation":[]},{"given":"Lin","family":"Han","sequence":"additional","affiliation":[]},{"given":"Leifeng","family":"Liang","sequence":"additional","affiliation":[]},{"given":"Liling","family":"Long","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"issue":"3","key":"902_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209\u201349.","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"902_CR2","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1002\/ijc.10894","volume":"103","author":"AWM Lee","year":"2003","unstructured":"Lee AWM, Foo W, Mang O, Sze WM, Chappell R, Lau WH, Ko WM. Changing epidemiology of nasopharyngeal carcinoma in Hong Kong over a 20-year period (1980\u201399): an encouraging reduction in both incidence and mortality. Int J Cancer. 2003;103(5):680\u20135.","journal-title":"Int J Cancer"},{"issue":"10","key":"902_CR3","doi-asserted-by":"publisher","first-page":"2256","DOI":"10.1002\/ijc.30660","volume":"140","author":"G Carioli","year":"2017","unstructured":"Carioli G, Negri E, Kawakita D, Garavello W, La Vecchia C, Malvezzi M. Global trends in nasopharyngeal cancer mortality since 1970 and predictions for 2020: Focus on low-risk areas. Int J Cancer. 2017;140(10):2256\u201364.","journal-title":"Int J Cancer"},{"issue":"15","key":"902_CR4","doi-asserted-by":"publisher","first-page":"6729","DOI":"10.7314\/APJCP.2015.16.15.6729","volume":"16","author":"Z-X Xu","year":"2015","unstructured":"Xu Z-X, Lin Z-X, Fang J-Y, Wu K-S, Du P-L, Zeng Y, Tang W-R, Xu X-L, Lin K. Mortality characteristic and prediction of nasopharyngeal carcinoma in China from 1991 to 2013. Asian Pac J Cancer Prev. 2015;16(15):6729\u201334.","journal-title":"Asian Pac J Cancer Prev"},{"issue":"3","key":"902_CR5","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.radonc.2014.02.003","volume":"110","author":"AWM Lee","year":"2014","unstructured":"Lee AWM, Ng WT, Chan LLK, Hung WM, Chan CCC, Sze HCK, Chan OSH, Chang ATY, Yeung RMW. Evolution of treatment for nasopharyngeal cancer\u2014success and setback in the intensity-modulated radiotherapy era. Radiother Oncol. 2014;110(3):377\u201384.","journal-title":"Radiother Oncol"},{"issue":"1","key":"902_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13014-015-0401-0","volume":"10","author":"Y He","year":"2015","unstructured":"He Y, Zhou Q, Shen L, Zhao Y, Lei M, Wei R, Shen L, Cao S. A retrospective study of the prognostic value of MRI-derived residual tumors at the end of intensity-modulated radiotherapy in 358 patients with locally-advanced nasopharyngeal carcinoma. Radiat Oncol. 2015;10(1):1\u201310.","journal-title":"Radiat Oncol"},{"key":"902_CR7","doi-asserted-by":"publisher","DOI":"10.1177\/1533033820957035","author":"P-Y Liao","year":"2020","unstructured":"Liao P-Y, Dong Z-Y, Huang C-T, Tang X-R, Liu G-D, Zhu L, Wu D-H. Development and validation of a prognostic nomogram based on residual tumor in patients with nondisseminated nasopharyngeal carcinoma. Technol Cancer Res Treat. 2020. https:\/\/doi.org\/10.1177\/1533033820957035.","journal-title":"Technol Cancer Res Treat"},{"issue":"7","key":"902_CR8","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1200\/JCO.20.03237","volume":"39","author":"YP Chen","year":"2021","unstructured":"Chen YP, Ismaila N, Chua MLK, Colevas AD, Haddad R, Huang SH, Wee JTS, Whitley AC, Yi JL, Yom SS, et al. Chemotherapy in combination with radiotherapy for definitive-intent treatment of stage II-IVA nasopharyngeal carcinoma: CSCO and ASCO guideline. J Clin Oncol: Off J Am Soc Clin Oncol. 2021;39(7):840\u201359.","journal-title":"J Clin Oncol: Off J Am Soc Clin Oncol"},{"issue":"7","key":"902_CR9","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1002\/(SICI)1097-0142(19990401)85:7<1446::AID-CNCR4>3.0.CO;2-3","volume":"85","author":"DL Kwong","year":"1999","unstructured":"Kwong DL, Nicholls J, Wei WI, Chua DT, Sham JS, Yuen PW, Cheng AC, Wan KY, Kwong PW, Choy DT. The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma. Cancer. 1999;85(7):1446\u201353.","journal-title":"Cancer"},{"issue":"1","key":"902_CR10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1148\/radiol.2491071753","volume":"249","author":"M Comoretto","year":"2008","unstructured":"Comoretto M, Balestreri L, Borsatti E, Cimitan M, Franchin G, Lise M. Detection and restaging of residual and\/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET\/CT. Radiology. 2008;249(1):203\u201311.","journal-title":"Radiology"},{"issue":"9","key":"902_CR11","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1007\/s00330-010-1784-9","volume":"20","author":"S-H Ng","year":"2010","unstructured":"Ng S-H, Chan S-C, Yen T-C, Liao C-T, Chang JT-C, Ko S-F, Wang H-M, Lin C-Y, Chang K-P, Lin Y-C. Comprehensive imaging of residual\/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT. Eur Radiol. 2010;20(9):2229\u201340.","journal-title":"Eur Radiol"},{"issue":"4","key":"902_CR12","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.ejca.2011.11.036","volume":"48","author":"P Lambin","year":"2012","unstructured":"Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RGPM, Granton P, Zegers CML, Gillies R, Boellard R, Dekker A, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48(4):441\u20136.","journal-title":"Eur J Cancer"},{"issue":"2","key":"902_CR13","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1148\/radiol.2015151169","volume":"278","author":"RJ Gillies","year":"2016","unstructured":"Gillies RJ, Kinahan PE, Hricak H. Radiomics: images are more than pictures, they are data. Radiology. 2016;278(2):563\u201377.","journal-title":"Radiology"},{"key":"902_CR14","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.ejrad.2017.11.007","volume":"98","author":"G Wang","year":"2018","unstructured":"Wang G, He L, Yuan C, Huang Y, Liu Z, Liang C. Pretreatment MR imaging radiomics signatures for response prediction to induction chemotherapy in patients with nasopharyngeal carcinoma. Eur J Radiol. 2018;98:100\u20136.","journal-title":"Eur J Radiol"},{"key":"902_CR15","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3389\/fonc.2020.00618","volume":"10","author":"H Shen","year":"2020","unstructured":"Shen H, Wang Y, Liu D, Lv R, Huang Y, Peng C, Jiang S, Wang Y, He Y, Lan X, et al. Predicting progression-free survival using MRI-based radiomics for patients with nonmetastatic nasopharyngeal carcinoma. Front Oncol. 2020;10:618.","journal-title":"Front Oncol"},{"issue":"15","key":"902_CR16","doi-asserted-by":"publisher","first-page":"4259","DOI":"10.1158\/1078-0432.CCR-16-2910","volume":"23","author":"B Zhang","year":"2017","unstructured":"Zhang B, Tian J, Dong D, Gu D, Dong Y, Zhang L, Lian Z, Liu J, Luo X, Pei S, et al. Radiomics features of multiparametric MRI as novel prognostic factors in advanced nasopharyngeal carcinoma. Clin Cancer Res. 2017;23(15):4259\u201369.","journal-title":"Clin Cancer Res"},{"key":"902_CR17","doi-asserted-by":"publisher","first-page":"102963","DOI":"10.1016\/j.ebiom.2020.102963","volume":"59","author":"S Roy","year":"2020","unstructured":"Roy S, Whitehead TD, Quirk JD, Salter A, Ademuyiwa FO, Li S, An H, Shoghi KI. Optimal co-clinical radiomics: sensitivity of radiomic features to tumour volume, image noise and resolution in co-clinical T1-weighted and T2-weighted magnetic resonance imaging. EBioMedicine. 2020;59:102963.","journal-title":"EBioMedicine"},{"issue":"1","key":"902_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40880-016-0103-5","volume":"35","author":"H-Y Wang","year":"2016","unstructured":"Wang H-Y, Chang Y-L, To K-F, Hwang JSG, Mai H-Q, Feng Y-F, Chang ET, Wang C-P, Kam MKM, Cheah S-L, et al. A new prognostic histopathologic classification of nasopharyngeal carcinoma. Chin J Cancer. 2016;35(1):1\u201316.","journal-title":"Chin J Cancer"},{"key":"902_CR19","unstructured":"National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology, head and neck cancers, Version 1. 2015."},{"key":"902_CR20","unstructured":"National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology, head and neck cancers, Version 2. 2017."},{"issue":"5","key":"902_CR21","doi-asserted-by":"publisher","first-page":"861","DOI":"10.7150\/jca.17957","volume":"8","author":"J-W Lv","year":"2017","unstructured":"Lv J-W, Zhou G-Q, Li J-X, Tang L-L, Mao Y-P, Lin A-H, Ma J, Sun Y. Magnetic resonance imaging-detected tumor residue after intensity-modulated radiation therapy and its association with post-radiation plasma Epstein\u2013Barr virus deoxyribonucleic acid in nasopharyngeal carcinoma. J Cancer. 2017;8(5):861\u20139.","journal-title":"J Cancer"},{"issue":"3","key":"902_CR22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.5732\/cjc.011.10279","volume":"31","author":"FY Liang","year":"2012","unstructured":"Liang FY, Sun W, Han P, Lu X, Lian YN, Huang XM. Detecting plasma Epstein\u2013Barr virus DNA to diagnose postradiation nasopharyngeal skull base lesions in nasopharyngeal carcinoma patients: a prospective study. Chin J Cancer. 2012;31(3):142\u20139.","journal-title":"Chin J Cancer"},{"issue":"5","key":"902_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v039.i05","volume":"39","author":"N Simon","year":"2011","unstructured":"Simon N, Friedman J, Hastie T, Tibshirani R. Regularization paths for Cox\u2019s proportional hazards model via coordinate descent. J Stat Softw. 2011;39(5):1\u201313.","journal-title":"J Stat Softw"},{"key":"902_CR24","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.3389\/fonc.2019.01179","volume":"9","author":"Y Zhu","year":"2019","unstructured":"Zhu Y, Song X, Li R, Quan H, Yan L. Assessment of nasopharyngeal cancer in young patients aged \u2264 30 years. Front Oncol. 2019;9:1179.","journal-title":"Front Oncol"},{"key":"902_CR25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.oraloncology.2017.08.006","volume":"73","author":"S-G Wu","year":"2017","unstructured":"Wu S-G, Liao X-L, He Z-Y, Tang L-Y, Chen X-T, Wang Y, Lin Q. Demographic and clinicopathological characteristics of nasopharyngeal carcinoma and survival outcomes according to age at diagnosis: a population-based analysis. Oral Oncol. 2017;73:83\u20137.","journal-title":"Oral Oncol"},{"key":"902_CR26","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.radonc.2021.06.029","volume":"162","author":"X-S Sun","year":"2021","unstructured":"Sun X-S, Xie S-Y, Luo D-H, Liu L-T, Guo S-S, Liu S-L, Tang L-Q, Chen Q-Y, Mai H-Q. Impact of smoking on survival in nasopharyngeal carcinoma: a cohort study with 23,325 patients diagnosed from 1990 to 2016. Radiother Oncol. 2021;162:7\u201317.","journal-title":"Radiother Oncol"},{"issue":"9","key":"902_CR27","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1038\/bjc.2015.70","volume":"112","author":"PY OuYang","year":"2015","unstructured":"OuYang PY, Zhang LN, Lan XW, Xie C, Zhang WW, Wang QX, Su Z, Tang J, Xie FY. The significant survival advantage of female sex in nasopharyngeal carcinoma: a propensity-matched analysis. Br J Cancer. 2015;112(9):1554\u201361.","journal-title":"Br J Cancer"},{"issue":"16_suppl","key":"902_CR28","doi-asserted-by":"publisher","first-page":"5549","DOI":"10.1200\/jco.2005.23.16_suppl.5549","volume":"23","author":"SW Shin","year":"2005","unstructured":"Shin SW, Sung WJ, Lee JW, Jung JS, Kim SJ, Seo JH, Kim YH, Kim JS, Choi IK. Serum albumin as an independent prognostic indicator in patients with advanced head and neck cancer treated with concurrent chemoradiotherapy. J Clin Oncol. 2005;23(16_suppl):5549\u20135549.","journal-title":"J Clin Oncol"},{"key":"902_CR29","doi-asserted-by":"publisher","first-page":"101352","DOI":"10.1016\/j.tranon.2022.101352","volume":"18","author":"Z Chuanji","year":"2022","unstructured":"Chuanji Z, Zheng W, Shaolv L, Linghou M, Yixin L, Xinhui L, Ling L, Yunjing T, Shilai Z, Shaozhou M, et al. Comparative study of radiomics, tumor morphology, and clinicopathological factors in predicting overall survival of patients with rectal cancer before surgery. Transl Oncol. 2022;18:101352.","journal-title":"Transl Oncol"},{"issue":"1","key":"902_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12943-017-0600-4","volume":"16","author":"PR Prasetyanti","year":"2017","unstructured":"Prasetyanti PR, Medema JP. Intra-tumor heterogeneity from a cancer stem cell perspective. Mol Cancer. 2017;16(1):1\u20139.","journal-title":"Mol Cancer"},{"issue":"2","key":"902_CR31","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1038\/nrclinonc.2017.166","volume":"15","author":"I Dagogo-Jack","year":"2017","unstructured":"Dagogo-Jack I, Shaw AT. Tumour heterogeneity and resistance to cancer therapies. Nat Rev Clin Oncol. 2017;15(2):81\u201394.","journal-title":"Nat Rev Clin Oncol"},{"issue":"6","key":"902_CR32","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1148\/rg.2021210037","volume":"41","author":"JD Shur","year":"2021","unstructured":"Shur JD, Doran SJ, Kumar S, Ap Dafydd D, Downey K, O\u2019Connor JPB, Papanikolaou N, Messiou C, Koh D-M, Orton MR. Radiomics in oncology: a practical guide. Radiographics. 2021;41(6):1717\u201332.","journal-title":"Radiographics"},{"issue":"9","key":"902_CR33","doi-asserted-by":"publisher","first-page":"2715","DOI":"10.7150\/jca.56397","volume":"12","author":"W Li","year":"2021","unstructured":"Li W, Yang C, Lv Z, Li J, Li Z, Yuan X, Wu S, Yuan Y, Cui L, Lu J, et al. Integrating pre- and post-treatment Plasma Epstein\u2013Barr Virus DNA levels for better prognostic prediction of Nasopharyngeal Carcinoma. J Cancer. 2021;12(9):2715\u201322.","journal-title":"J Cancer"},{"issue":"8","key":"902_CR34","doi-asserted-by":"publisher","first-page":"e24555","DOI":"10.1097\/MD.0000000000024555","volume":"100","author":"C-C Lee","year":"2021","unstructured":"Lee C-C, Lee J-C, Huang W-Y, Juan C-J, Jen Y-M, Lin L-F. Image-based diagnosis of residual or recurrent nasopharyngeal carcinoma may be a phantom tumor phenomenon. Medicine. 2021;100(8):e24555.","journal-title":"Medicine"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00902-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-022-00902-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-022-00902-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T12:03:05Z","timestamp":1664884985000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-022-00902-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,4]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["902"],"URL":"https:\/\/doi.org\/10.1186\/s12880-022-00902-6","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,4]]},"assertion":[{"value":"29 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Medical Ethics Committee of First Affiliated Hospital of Guangxi Medical University approved the study (NO. 2022-KY-E-249), and the informed consent of the patients was waived for the nature of the retrospective study. All methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"174"}}