{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:20:51Z","timestamp":1793830851731,"version":"4.6.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To construct radiomics models based on MRI at different time points for the early prediction of cystic brain radionecrosis (CBRN) for nasopharyngeal carcinoma (NPC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 202 injured temporal lobes from 155 NPC patients with radiotherapy-induced temporal lobe injury (RTLI) after intensity modulated radiotherapy (IMRT) were included in the study. All the injured lobes were randomly divided into the training (<jats:italic>n<\/jats:italic>\u2009=\u2009143) and validation (<jats:italic>n<\/jats:italic>\u2009=\u200959) sets. Radiomics models were constructed by using features extracted from T2WI at two different time points: at the end of IMRT (post-IMRT) and the first-detected RTLI (first-RTLI). A delta-radiomics feature was defined as the percentage change in a radiomics feature from post-IMRT to first-RTLI. The radiomics nomogram was constructed by combining clinical risk factors and radiomics signatures using multivariate logistic regression analysis. Predictive performance was evaluated using area under the curve (AUC) from receiver operating characteristic analysis and decision curve analysis (DCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The post-IMRT, first-RTLI, and delta-radiomics models yielded AUC values of 0.84 (95% CI: 0.76\u20130.92), 0.86 (95% CI: 0.78\u20130.94), and 0.77 (95% CI: 0.67\u20130.87), respectively. The nomogram exhibited the highest AUC of 0.91 (95% CI: 0.85\u20130.97) and sensitivity of 0.82 compared to any single radiomics model. From the DCA, the nomogram model provided more clinical benefit than the radiomics models or clinical model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The radiomics nomogram model combining clinical factors and radiomics signatures based on MRI at different time points after radiotherapy showed excellent prediction potential for CBRN in patients with NPC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1344324","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T12:17:49Z","timestamp":1717071469000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["MRI-based radiomics models predict cystic brain radionecrosis of nasopharyngeal carcinoma after intensity modulated radiotherapy"],"prefix":"10.3389","volume":"15","author":[{"given":"Jing","family":"Hou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Handong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huashan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanmiao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1186\/1471-2407-13-397","article-title":"Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis","volume":"13","author":"Sun","year":"2013","journal-title":"BMC Cancer"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s13014-020-01560-0","article-title":"Radiation induced temporal lobe necrosis in nasopharyngeal cancer patients after radical external beam radiotherapy","volume":"15","author":"Wu","year":"2020","journal-title":"Radiat Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1016\/S0140-6736(09)61299-X","article-title":"CNS complications of radiotherapy and chemotherapy","volume":"374","author":"Soussain","year":"2009","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1148\/radiol.09090428","article-title":"Evolution of radiation-induced brain injury: MR imaging-based study","volume":"254","author":"Wang","year":"2010","journal-title":"Radiology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"715","DOI":"10.3892\/ol.2017.6199","article-title":"Dynamic MRI follow-up of radiation encephalopathy in the temporal lobe following nasopharyngeal carcinoma radiotherapy","volume":"14","author":"Zhou","year":"2017","journal-title":"Oncol Lett"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1093\/jjco\/hyx028","article-title":"Late-onset cystic brain necrosis after radiotherapy for nasopharyngeal carcinoma","volume":"47","author":"Fang","year":"2017","journal-title":"Jpn J Clin Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1016\/j.ijrobp.2010.11.070","article-title":"Clinical outcomes of 174 nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis","volume":"82","author":"Lam","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"365","DOI":"10.2967\/jnumed.116.184655","article-title":"Radiomics in PET\/CT: more than meets the eye?","volume":"58","author":"Hatt","year":"2017","journal-title":"J Nucl Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1148\/radiol.13132195","article-title":"Behind the numbers: decoding molecular phenotypes with radiogenomics--guiding principles and technical considerations","volume":"270","author":"Kuo","year":"2014","journal-title":"Radiology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"6910","DOI":"10.1007\/s00330-022-08853-w","article-title":"A MRI-based radiomics model predicting radiation-induced temporal lobe injury in nasopharyngeal carcinoma","volume":"32","author":"Bao","year":"2022","journal-title":"Eur Radiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2842","DOI":"10.1002\/hed.27200","article-title":"Magnetic resonance imaging-based radiomics model for predicting radiation-induced temporal lobe injury in nasopharyngeal carcinoma after intensity-modulated radiotherapy","volume":"44","author":"Bao","year":"2022","journal-title":"Head Neck"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e482","DOI":"10.1016\/j.clon.2022.07.007","article-title":"Nomogram based on clinical and radiomics data for predicting radiation-induced temporal lobe injury in patients with non-metastatic stage T4 nasopharyngeal carcinoma","volume":"34","author":"Bin","year":"2022","journal-title":"Clin Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1007\/s00330-021-08254-5","article-title":"MRI-based radiomics nomogram for predicting temporal lobe injury after radiotherapy in nasopharyngeal carcinoma","volume":"32","author":"Hou","year":"2022","journal-title":"Eur Radiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1186\/s12885-020-06957-4","article-title":"Machine-learning based MRI radiomics models for early detection of radiation-induced brain injury in nasopharyngeal carcinoma","volume":"20","author":"Zhang","year":"2020","journal-title":"BMC Cancer"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1135978","DOI":"10.3389\/fneur.2023.1135978","article-title":"MRI-based radiomics models for the early prediction of radiation-induced temporal lobe injury in nasopharyngeal carcinoma","volume":"14","author":"Huang","year":"2023","journal-title":"Front Neurol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.21037\/tcr-23-859","article-title":"Predictive accuracy of machine learning for radiation-induced temporal lobe injury in nasopharyngeal carcinoma patients: a systematic review and meta-analysis","volume":"12","author":"Li","year":"2023","journal-title":"Transl Cancer Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more \"personalized\" approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"873","DOI":"10.6004\/jnccn.2020.0031","article-title":"Head and neck cancers, version 2.2020, NCCN clinical practice guidelines in oncology","volume":"18","author":"Pfister","year":"2020","journal-title":"J Natl Compr Cancer Netw"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1109\/TPAMI.2005.159","article-title":"Feature selection based on mutual information: criteria of max-dependency, max-relevance, and min-redundancy","volume":"27","author":"Peng","year":"2005","journal-title":"IEEE Trans Pattern Anal Mach Intell"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"5512","DOI":"10.1002\/sim.3148","article-title":"Selection of important variables and determination of functional form for continuous predictors in multivariable model building","volume":"26","author":"Sauerbrei","year":"2007","journal-title":"Stat Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.ijrobp.2014.05.036","article-title":"Effect of dosimetric factors on occurrence and volume of temporal lobe necrosis following intensity modulated radiation therapy for nasopharyngeal carcinoma: a case-control study","volume":"90","author":"Zhou","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/s0360-3016(97)00580-4","article-title":"Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma","volume":"40","author":"Lee","year":"1998","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"594494","DOI":"10.3389\/fonc.2020.594494","article-title":"Development and validation of a nomogram for predicting radiation-induced temporal lobe injury in nasopharyngeal carcinoma","volume":"10","author":"Guan","year":"2020","journal-title":"Front Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"26378","DOI":"10.1038\/srep26378","article-title":"LASSO-based NTCP model for radiation-induced temporal lobe injury developing after intensity-modulated radiotherapy of nasopharyngeal carcinoma","volume":"6","author":"Kong","year":"2016","journal-title":"Sci Rep"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s13014-019-1229-9","article-title":"Dosimetric predictors of temporal lobe injury after intensity-modulated radiotherapy for T4 nasopharyngeal carcinoma: a competing risk study","volume":"14","author":"Huang","year":"2019","journal-title":"Radiat Oncol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.radonc.2012.06.012","article-title":"Clinical and dosimetric characteristics of temporal lobe injury following intensity modulated radiotherapy of nasopharyngeal carcinoma","volume":"104","author":"Su","year":"2012","journal-title":"Radiother Oncol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s13014-019-1250-z","article-title":"Development and validation of a model for temporal lobe necrosis for nasopharyngeal carcinoma patients with intensity modulated radiation therapy","volume":"14","author":"Wang","year":"2019","journal-title":"Radiat Oncol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1344324\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T12:17:52Z","timestamp":1717071472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1344324\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,30]]},"references-count":27,"alternative-id":["10.3389\/fneur.2024.1344324"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1344324","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,30]]},"article-number":"1344324"}}