Outcome prediction of head and neck squamous cell carcinoma by MRI radiomic signatures

Steven W Mes, Floris H P van Velden, Boris Peltenburg, Carel F W Peeters, Dennis E Te Beest, Mark A van de Wiel, Joost Mekke, Doriene C Mulder, Roland M Martens, Jonas A Castelijns, Frank A Pameijer, Remco de Bree, Ronald Boellaard, C René Leemans, Ruud H Brakenhoff, Pim de Graaf

Research output: Contribution to journalArticleAcademicpeer-review

42 Citations (Scopus)


OBJECTIVES: Head and neck squamous cell carcinoma (HNSCC) shows a remarkable heterogeneity between tumors, which may be captured by a variety of quantitative features extracted from diagnostic images, termed radiomics. The aim of this study was to develop and validate MRI-based radiomic prognostic models in oral and oropharyngeal cancer.

MATERIALS AND METHODS: Native T1-weighted images of four independent, retrospective (2005-2013), patient cohorts (n = 102, n = 76, n = 89, and n = 56) were used to delineate primary tumors, and to extract 545 quantitative features from. Subsequently, redundancy filtering and factor analysis were performed to handle collinearity in the data. Next, radiomic prognostic models were trained and validated to predict overall survival (OS) and relapse-free survival (RFS). Radiomic features were compared to and combined with prognostic models based on standard clinical parameters. Performance was assessed by integrated area under the curve (iAUC).

RESULTS: In oral cancer, the radiomic model showed an iAUC of 0.69 (OS) and 0.70 (RFS) in the validation cohort, whereas the iAUC in the oropharyngeal cancer validation cohort was 0.71 (OS) and 0.74 (RFS). By integration of radiomic and clinical variables, the most accurate models were defined (iAUC oral cavity, 0.72 (OS) and 0.74 (RFS); iAUC oropharynx, 0.81 (OS) and 0.78 (RFS)), and these combined models outperformed prognostic models based on standard clinical variables only (p < 0.001).

CONCLUSIONS: MRI radiomics is feasible in HNSCC despite the known variability in MRI vendors and acquisition protocols, and radiomic features added information to prognostic models based on clinical parameters.

KEY POINTS: • MRI radiomics can predict overall survival and relapse-free survival in oral and HPV-negative oropharyngeal cancer. • MRI radiomics provides additional prognostic information to known clinical variables, with the best performance of the combined models. • Variation in MRI vendors and acquisition protocols did not influence performance of radiomic prognostic models.

Original languageEnglish
Pages (from-to)6311-6321
Number of pages11
JournalEuropean Radiology
Issue number11
Early online date4 Jun 2020
Publication statusPublished - 1 Nov 2020


  • Factor analysis
  • Head and neck neoplasms
  • Magnetic resonance imaging
  • Prognosis

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