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- Title
Added value of histogram analysis of ADC in predicting radiation-induced temporal lobe injury of patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy.
- Authors
Bao, Dan; Zhao, Yanfeng; Wu, Wenli; Zhong, Hongxia; Yuan, Meng; Li, Lin; Lin, Meng; Zhao, Xinming; Luo, Dehong
- Abstract
Background: This study evaluated the predictive potential of histogram analysis derived from apparent diffusion coefficient (ADC) maps in radiation-induced temporal lobe injury (RTLI) of nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT). Results: Pretreatment diffusion-weighted imaging (DWI) of the temporal lobes of 214 patients with NPC was retrospectively analyzed to obtain ADC histogram parameters. Of the 18 histogram parameters derived from ADC maps, 7 statistically significant variables in the univariate analysis were included in the multivariate logistic regression analysis. The final best prediction model selected by backward stepwise elimination with Akaike information criteria as the stopping rule included kurtosis, maximum energy, range, and total energy. A Rad-score was established by combining the four variables, and it provided areas under the curve (AUCs) of 0.95 (95% confidence interval [CI] 0.91–0.98) and 0.89 (95% CI 0.81–0.97) in the training and validation cohorts, respectively. The combined model, integrating the Rad-score with the T stage (p = 0.02), showed a favorable prediction performance in the training and validation cohorts (AUC = 0.96 and 0.87, respectively). The calibration curves showed a good agreement between the predicted and actual RTLI occurrences. Conclusions: Pretreatment histogram analysis of ADC maps and their combination with the T stage showed a satisfactory ability to predict RTLI in NPC after IMRT. Key points: Histogram parameters from pretreatment ADC maps are associated with RTLI in NPC. The ADC and combined models show better performance than the T stage alone. The combined model shows excellent performance in predicting RTLI in different subgroups.
- Subjects
TEMPORAL lobe; NASOPHARYNX cancer; INTENSITY modulated radiotherapy; HISTOGRAMS; DIFFUSION magnetic resonance imaging
- Publication
Insights into Imaging, 2022, Vol 13, Issue 1, p1
- ISSN
1869-4101
- Publication type
Article
- DOI
10.1186/s13244-022-01338-w