ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
This article is part of the Research TopicBased Models and Machine Learning on CT, MRI and PET-CT in Head and Neck Cancer Diagnosis, Staging and Outcome PredictionView all 3 articles
Dual-energy CT-Based Nomogram for Predicting Progression-Free Survival in Locally Advanced Nasopharyngeal Carcinoma
Provisionally accepted
- 1Guangxi Medical University Cancer Hospital, Nanning, China
- 2Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
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Purpose:To establish a dual-energy CT (DECT) based nomogram for predicting progression-free survival (PFS) in locally advanced nasopharyngeal carcinoma (LANPC). Methods:In this retrospective study, 52 LANPC patients who underwent DECT scans and post-treatment follow-up (median follow-up = 42.2 months) were enrolled. DECT parameters of tumor lesions including iodine concentration (IC), normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit (HU) curve (λHU), and effective atomic number (Zeff) were analyzed to predict PFS. A nomogram integrating clinical data and DECT-derived parameters was constructed. The model's performance was evaluated using calibration curves, Harrell's concordance index (C-index), and receiver operating characteristic (ROC) curve. Results:NIC, neutrophil-to-lymphocyte ratio (NLR), and lactate dehydrogenase (LDH) were the independent prognostic factors for PFS, and were incorporated into constructing the nomogram. Calibration plots demonstrated strong agreement between predicted and observed PFS rates. The C-index for the nomogram was 0.88 (95% confidence interval [CI]: 0.80–0.90). The nomogram model demonstrated predictive accuracy for PFS, with the area under the ROC curves (AUCs) of 0.939, 0.880, and 0.879 at 1-, 2-, and 3-year, respectively. Conclusion:The DECT-based nomogram exhibited excellent predictive accuracy for PFS in LANPC patients, highlighting its potential as a valuable clinical tool.
Keywords: Dual-energy CT, nasopharyngeal carcinoma, nomogram, Progression-free survival, prognosis
Received: 04 Sep 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Pei, Wang, Wei, Xie, Su and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hai Liao, 42442427@qq.com
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