MRI-based Radiomics Analysis For Preoperative Evaluation Of Lymph Node Metastasis In Hypopharyngeal Squamous Cell Carcinoma

Objective: To investigate the role of pre-treatment magnetic resonance imaging(MRI)radiomics for the preoperative prediction of lymph node(LN)metastasis in patients with hypopharyngeal squamous cell carcinoma(HPSCC).Methods: A total of 155 patients with HPSCC were eligibly enrolled from single institution.Radiomics features were extracted from contrastenhanced axial T1-weighted(CE-T1WI)sequence.The most relevant features to LN metastasis were selected by the least absolute shrinkage and selection operator(LASSO)method.Univariate and multivariate logistic regression analysis was adopted to determine the independent clinical risk factors.Three models were constructed to predict the LN metastasis status: one for radiomics only,one for clinical factors only,and the other one combined radiomics and clinical factors.Receiver operating characteristic(ROC)curves and calibration curve were used to evaluate the discrimination and the accuracy of the models,respectively.The performances were tested by an independent validation cohort.The clinical utility of the models was assessed by decision curve analysis.Results: The nomogram consisted of radiomics scores and the MRIreported LN status showed satisfactory discrimination in the training and validation cohorts with AUCs of 0.906(95% CI,0.840 to 0.902)and0.853(95% CI,0.739 to 0.966),respectively.The nomogram,i.e.,the combined model,outperformed the radiomics and MRI-reported LN status in both discrimination and clinical usefulness.Conclusions: The MRI-based radiomics nomogram holds promise for use as a noninvasive tool in the individual prediction of LN metastasis in patients with HPSCC.