Development and Validation of a Deep Learning Model to Predict Distant Metastases in Nasopharyngeal Carcinoma Using Whole Slide Imaging and MRI
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In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Nasopharyngeal Cancinoma (NPC), Distant Metastasis. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Development and Multicenter Validation of a Deep Learning Model Based on Whole Slide Imaging and Magnetic Resonance Imaging of the Nasopharynx and Lymph Nodes to Predict Distant Metastases at Diagnosis in Nasopharyngeal Carcinoma
Overview
An AI model was developed to predict the likelihood of distant metastasis in patients with nasopharyngeal cancer based on pathology slides and MRI scans of the primary tumor. The model was validated using data from multiple centers. It was then applied to patients with advanced stages who were recommended to undergo PET/CT scans based on the NCCN or CSCO guidelines. This AI model can accurately screen patients with high risk of distant metastasis at the time of initial diagnosis to receive PET/CT, avoid excessive examination of patients with low risk of distant metastasis, save medical resources and reduce the economic burden on patients.
Detailed description
An AI model was constructed based on HE-stained pathological sections of the primary lesion and MRI of the nasopharynx and neck to predict the probability of distant metastasis at the first visit, and the AI model was fully verified by multicenter data; the AI model was applied to T3-4 or N2-3 patients who were recommended to undergo PET/CT examination according to the NCCN and CSCO guidelines, and the threshold of the AI model when the negative predictive value for predicting M0 was not less than 95% was determined, providing theoretical support for patients predicted by AI to be exempted from PET/CT examination.
Primary outcome measures
- Negative predictive value [Time frame: through study completion, an average of 2 year]
Secondary outcome measures (1)
- Sensitivity, specificity, and positive predictive value [Time frame: through study completion, an average of 2 year]
Eligibility criteria
Inclusion criteria
A. The primary lesion was pathologically confirmed as nasopharyngeal carcinoma (WHO classification is I, II and III); B. The stage was T3-4 or N2-3, and the nasopharynx + neck MRI plain scan and enhanced scan were performed to confirm the nasopharyngeal and cervical lymph node lesions, and PET/CT or conventional examination (chest CT plain scan + enhanced scan, upper abdominal CT or MRI plain scan + enhanced scan or abdominal color Doppler ultrasound or ultrasound angiography, and whole body bone imaging) was performed to screen for distant metastases.
Exclusion criteria
Previous history of other malignant tumors (such as other head and neck squamous cell carcinomas, thyroid cancer, breast cancer, esophageal cancer, etc.).
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
China · 2 centers
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center — Guangzhou
- Sun Yat-sen University Cancer Center — Guangzhou
Publications
- Zhong L, Dong D, Fang X, Zhang F, Zhang N, Zhang L, Fang M, Jiang W, Liang S, Li C, Liu Y, Zhao X, Cao R, Shan H, Hu Z, Ma J, Tang L, Tian J. A deep learning-based radiomic nomogram for prognosis and treatment decision in advanced nasopharyngeal carcinoma: A multicentre study. EBioMedicine. 2021 Aug;70:103522. doi: 10.1016/j.ebiom.2021.103522. Epub 2021 Aug 11. PMID 34391094
- Qiang M, Li C, Sun Y, Sun Y, Ke L, Xie C, Zhang T, Zou Y, Qiu W, Gao M, Li Y, Li X, Zhan Z, Liu K, Chen X, Liang C, Chen Q, Mai H, Xie G, Guo X, Lv X. A Prognostic Predictive System Based on Deep Learning for Locoregionally Advanced Nasopharyngeal Carcinoma. J Natl Cancer Inst. 2021 May 4;113(5):606-615. doi: 10.1093/jnci/djaa149. PMID 32970812
- Lin L, Dou Q, Jin YM, Zhou GQ, Tang YQ, Chen WL, Su BA, Liu F, Tao CJ, Jiang N, Li JY, Tang LL, Xie CM, Huang SM, Ma J, Heng PA, Wee JTS, Chua MLK, Chen H, Sun Y. Deep Learning for Automated Contouring of Primary Tumor Volumes by MRI for Nasopharyngeal Carcinoma. Radiology. 2019 Jun;291(3):677-686. doi: 10.1148/radiol.2019182012. Epub 2019 Mar 26. PMID 30912722
- OuYang PY, Zhang BY, Guo JG, Liu JN, Li J, Peng QH, Yang SS, He Y, Liu ZQ, Zhao YN, Li A, Wu YS, Hu XF, Chen C, Han F, You KY, Xie FY. Deep learning-based precise prediction and early detection of radiation-induced temporal lobe injury for nasopharyngeal carcinoma. EClinicalMedicine. 2023 Apr 4;58:101930. doi: 10.1016/j.eclinm.2023.101930. eCollection 2023 Apr. PMID 37090437
- OuYang PY, He Y, Guo JG, Liu JN, Wang ZL, Li A, Li J, Yang SS, Zhang X, Fan W, Wu YS, Liu ZQ, Zhang BY, Zhao YN, Gao MY, Zhang WJ, Xie CM, Xie FY. Artificial intelligence aided precise detection of local recurrence on MRI for nasopharyngeal carcinoma: a multicenter cohort study. EClinicalMedicine. 2023 Aug 30;63:102202. doi: 10.1016/j.eclinm.2023.102202. eCollection 2023 Sep. PMID 37680944
- Sun XS, Liu SL, Luo MJ, Li XY, Chen QY, Guo SS, Wen YF, Liu LT, Xie HJ, Tang QN, Liang YJ, Yan JJ, Lin DF, Bi MM, Liu Y, Liang YF, Ma J, Tang LQ, Mai HQ. The Association Between the Development of Radiation Therapy, Image Technology, and Chemotherapy, and the Survival of Patients With Nasopharyngeal Carcinoma: A Cohort Study From 1990 to 2012. Int J Radiat Oncol Biol Phys. 2019 Nov 1;105(3):581-59 PMID 31319091
- Tang LQ, Chen QY, Fan W, Liu H, Zhang L, Guo L, Luo DH, Huang PY, Zhang X, Lin XP, Mo YX, Liu LZ, Mo HY, Li J, Zou RH, Cao Y, Xiang YQ, Qiu F, Sun R, Chen MY, Hua YJ, Lv X, Wang L, Zhao C, Guo X, Cao KJ, Qian CN, Zeng MS, Mai HQ. Prospective study of tailoring whole-body dual-modality [18F]fluorodeoxyglucose positron emission tomography/computed tomography with plasma Epstein-Barr virus DNA for de PMID 23857969
- Xiao BB, Lin DF, Sun XS, Zhang X, Guo SS, Liu LT, Luo DH, Sun R, Wen YF, Li JB, Lv XF, Han LJ, Yuan L, Liu SL, Tang QN, Liang YJ, Li XY, Guo L, Chen QY, Fan W, Mai HQ, Tang LQ. Nomogram for the prediction of primary distant metastasis of nasopharyngeal carcinoma to guide individualized application of FDG PET/CT. Eur J Nucl Med Mol Imaging. 2021 Jul;48(8):2586-2598. doi: 10.1007/s00259-020-05128-8. PMID 33420610
Identifiers
NCT: NCT06831357 · B2025-062-01