Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study

Abstract Background Previous studies utilizing dual-energy CT (DECT) for evaluating treatment efficacy in nasopharyngeal cancinoma (NPC) are limited. This study aimed to investigate whether the parameters from DECT can predict the response to induction chemotherapy in NPC patients in two centers. Me...

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Main Authors: Huanhuan Ren, Junhao Huang, Yao Huang, Bangyuan Long, Mei Zhang, Jing Zhang, Huarong Li, Tingting Huang, Daihong Liu, Ying Wang, Jiuquan Zhang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Cancer Imaging
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Online Access:https://doi.org/10.1186/s40644-025-00827-7
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author Huanhuan Ren
Junhao Huang
Yao Huang
Bangyuan Long
Mei Zhang
Jing Zhang
Huarong Li
Tingting Huang
Daihong Liu
Ying Wang
Jiuquan Zhang
author_facet Huanhuan Ren
Junhao Huang
Yao Huang
Bangyuan Long
Mei Zhang
Jing Zhang
Huarong Li
Tingting Huang
Daihong Liu
Ying Wang
Jiuquan Zhang
author_sort Huanhuan Ren
collection DOAJ
description Abstract Background Previous studies utilizing dual-energy CT (DECT) for evaluating treatment efficacy in nasopharyngeal cancinoma (NPC) are limited. This study aimed to investigate whether the parameters from DECT can predict the response to induction chemotherapy in NPC patients in two centers. Methods This two-center retrospective study included patients diagnosed with NPC who underwent contrast-enhanced DECT between March 2019 and November 2023. The clinical and DECT-derived parameters of tumor lesions were calculated to predict the response. We employed univariate and multivariate analysis to identify significant factors. Subsequently, the clinical, DECT, and clinical-DECT nomogram models were developed using independent predictors in the training cohort and validated in the test cohort. Receiver operating characteristic analysis was performed to evaluate the models’ performance. Results A total of 321 patients were included in the study, predominantly male [247 (76.9%)] with an average age of 52.04 ± 10.87 years. The training cohort (Center 1) comprised 252 patients, while the test cohort (Center 2) comprised 69 patients. Of these, 233 out of 321 patients (72.6%) were responders to induction chemotherapy. The clinical-DECT nomogram showed an AUC of 0.805 (95% CI, 0.688–0.906), outperforming both the DECT model (Extracellular volume fraction [ECVf]) (AUC, 0.706 [95% CI, 0.571–0.825]) and the clinical model (Ki67) (AUC, 0.693 [95% CI, 0.580–0.806]) in the test cohort. Conclusions Ki67 and ECVf emerged as independent predictive factors for response to induction chemotherapy in NPC patients. The proposed nomogram, incorporating ECVf, demonstrated accurate prediction of treatment response.
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spelling doaj-art-9cd0b4d096f4422f80f464be917a31472025-02-02T12:40:46ZengBMCCancer Imaging1470-73302025-01-0125111210.1186/s40644-025-00827-7Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center studyHuanhuan Ren0Junhao Huang1Yao Huang2Bangyuan Long3Mei Zhang4Jing Zhang5Huarong Li6Tingting Huang7Daihong Liu8Ying Wang9Jiuquan Zhang10Department of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing General HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalRadiation Oncology Center, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalAbstract Background Previous studies utilizing dual-energy CT (DECT) for evaluating treatment efficacy in nasopharyngeal cancinoma (NPC) are limited. This study aimed to investigate whether the parameters from DECT can predict the response to induction chemotherapy in NPC patients in two centers. Methods This two-center retrospective study included patients diagnosed with NPC who underwent contrast-enhanced DECT between March 2019 and November 2023. The clinical and DECT-derived parameters of tumor lesions were calculated to predict the response. We employed univariate and multivariate analysis to identify significant factors. Subsequently, the clinical, DECT, and clinical-DECT nomogram models were developed using independent predictors in the training cohort and validated in the test cohort. Receiver operating characteristic analysis was performed to evaluate the models’ performance. Results A total of 321 patients were included in the study, predominantly male [247 (76.9%)] with an average age of 52.04 ± 10.87 years. The training cohort (Center 1) comprised 252 patients, while the test cohort (Center 2) comprised 69 patients. Of these, 233 out of 321 patients (72.6%) were responders to induction chemotherapy. The clinical-DECT nomogram showed an AUC of 0.805 (95% CI, 0.688–0.906), outperforming both the DECT model (Extracellular volume fraction [ECVf]) (AUC, 0.706 [95% CI, 0.571–0.825]) and the clinical model (Ki67) (AUC, 0.693 [95% CI, 0.580–0.806]) in the test cohort. Conclusions Ki67 and ECVf emerged as independent predictive factors for response to induction chemotherapy in NPC patients. The proposed nomogram, incorporating ECVf, demonstrated accurate prediction of treatment response.https://doi.org/10.1186/s40644-025-00827-7Nasopharyngeal carcinomaTreatment outcomeInduction chemotherapyTomography, X-ray computedResponse
spellingShingle Huanhuan Ren
Junhao Huang
Yao Huang
Bangyuan Long
Mei Zhang
Jing Zhang
Huarong Li
Tingting Huang
Daihong Liu
Ying Wang
Jiuquan Zhang
Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
Cancer Imaging
Nasopharyngeal carcinoma
Treatment outcome
Induction chemotherapy
Tomography, X-ray computed
Response
title Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
title_full Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
title_fullStr Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
title_full_unstemmed Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
title_short Nomogram based on dual-energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma: a two-center study
title_sort nomogram based on dual energy computed tomography to predict the response to induction chemotherapy in patients with nasopharyngeal carcinoma a two center study
topic Nasopharyngeal carcinoma
Treatment outcome
Induction chemotherapy
Tomography, X-ray computed
Response
url https://doi.org/10.1186/s40644-025-00827-7
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