To our knowledge, this is the first MRI-based radiomics study to predicting survival of tumor. The results of our study show that multiparametric MRI-based radiomics nomogram significantly improves the 7th edition of AJCC TNM staging system and clinical data in predicting individualized progression-free survival (PFS) in advanced NPC (stage III-IVb). In fact, the radiomics nomogram built in our study could integrate all prognostic biomarkers/signatures that have been published in this area to improve its predictive performance. Besides, for the first time, our radiomics heatmaps showed positive associations between radiomics signature features with overall stage, T-stage and negative associations between radiomics signature features with N-stage. Our radiomics study provides some different insights into the mechanism of hematogenous and lymphatic metastasis of NPC.
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