Multicenter Study of Multimodal MRI Radiomics and Deep Learning-Based Segmentation for Predicting Local Recurrence of Nasopharyngeal Carcinoma.

Simple Summary: Predicting local recurrence in nasopharyngeal carcinoma (NPC) remains challenging using standard imaging assessment alone. This study developed and externally validated a prognostic framework using multimodal MRI radiomics based on expert-reviewed tumor regions and supplemented this...

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Publicado en:Cancers Vol. 18; no. 8; pp. 1265 - 1281
Autores principales: Yao, Dongfang, Lai, Yongjing, Bin, Xiang, Li, Jingyu, Chen, Biaoyou, Tang, Anzhou
Formato: diagnostic images research tables/charts Journal Article
Publicado: MDPI Apr2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2026
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      pub: MDPI
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        atl: Multicenter Study of Multimodal MRI Radiomics and Deep Learning-Based Segmentation for Predicting Local Recurrence of Nasopharyngeal Carcinoma.
      aug:
        au:
          Yao, Dongfang
          Lai, Yongjing
          Bin, Xiang
          Li, Jingyu
          Chen, Biaoyou
          Tang, Anzhou
        affil: Department of Otolaryngology–Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
      sug:
        subj:
          Nasopharyngeal Carcinoma Prognosis
          Neoplasm Recurrence, Local Prognosis
          Magnetic Resonance Imaging
          Radiomics
          Deep Learning
          Prediction Models
          Human
          Multicenter Studies
          Prospective Studies
          Retrospective Design
          Record Review
          Boosting Machine Learning Algorithms
          Sensitivity and Specificity
          Automation
          Machine Learning
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Predictive Value of Tests
          Data Analysis Software
          McNemar's Test
          Image Processing, Computer Assisted
          Chi Square Test
          Fisher's Exact Test
          Mann-Whitney U Test
          T-Tests
          Funding Source
      ab: Simple Summary: Predicting local recurrence in nasopharyngeal carcinoma (NPC) remains challenging using standard imaging assessment alone. This study developed and externally validated a prognostic framework using multimodal MRI radiomics based on expert-reviewed tumor regions and supplemented this by evaluating an automated deep learning tumor segmentation pipeline to enhance recurrence risk evaluation. Analyzing data from 1074 patients across two clinical centers, we found that integrating T1-weighted, T2-weighted, and contrast-enhanced MRI signals captures complementary features of intratumoral heterogeneity. While the deep learning segmentation module demonstrated consistent but moderate overlap with expert contours (reflecting the complex infiltrative boundaries of NPC), the derived prognostic model achieved high discriminative performance in an independent external validation cohort (AUC: 0.910). The multimodal model showed numerical improvement over single-sequence approaches, suggesting that fusing diverse imaging signals provides a more comprehensive assessment of individual recurrence risk. This objective tool may support personalized surveillance planning and prospective clinical decision-making for NPC patients. Background/Objectives: We developed and validated a multimodal magnetic resonance imaging (MRI) framework combining deep learning segmentation with radiomics to predict local recurrence in nasopharyngeal carcinoma (NPC). Methods: This retrospective two-center study included 1074 NPC patients treated between 2015 and 2019. Center 1 cases were split 8:2 into training and internal test sets, while Center 2 served for external validation. A multimodal Swin UNet model automatically segmented tumors from pretreatment T1-weighted, T2-weighted, and contrast-enhanced T1 (CET1) images. Radiomics features were extracted from expert-reviewed regions of interest, selected, and modeled using extreme gradient boosting for recurrence prediction. Results: The multimodal segmentation model maintained consistent but moderate Dice similarity coefficients (0.737, 0.666, and 0.726 for T1WI, T2WI, and CET1 in external validation). These values reflect the moderate overlap typical for nasopharyngeal carcinoma, given its highly infiltrative growth and ill-defined boundaries along complex anatomic interfaces. For local recurrence prediction, single-modality models reached external AUCs between 0.754 and 0.781. Importantly, the multimodal fusion model demonstrated numerical improvement over single modalities in the external validation set (e.g., vs. T1WI, p = 0.141), achieving an AUC of 0.910, accuracy of 0.908, sensitivity of 0.805, specificity of 0.946, and F1-score of 0.825. Conclusions: The multimodal MRI radiomics model, developed alongside a deep learning segmentation module, demonstrated favorable multicenter performance for evaluating NPC recurrence risk. The primary prognostic analysis was based on expert-reviewed regions of interest; a supplementary analysis using fully automatic segmentation masks yielded comparable, non-significantly different performance across all cohorts (Training AUC: 0.887; Internal Test AUC: 0.892; External Validation AUC: 0.885 vs. 0.910, p = 0.145), supporting the feasibility of future end-to-end deployment. Fusing multimodal features yielded numerical improvements over single-sequence models in external validation, providing a basis for post-treatment surveillance planning.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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