Review on applications of metastatic lymph node based radiomic assessment in nasopharyngeal carcinoma

Abstract

Nasopharyngeal carcinoma (NPC) has a distinct geographical prevalence in Southern China and Southeast Asia with a high overall survival rate (> 90%) in the early stage of the disease. However, almost 85% of patients suffer from the locally advanced disease with nodal metastasis at diagnosis. The overall survival rate would drastically drop to 63%. In addition to the generic tumor, nodal, and metastasis (TNM) staging, radiomic studies focusing on primary nasopharyngeal tumors have gained attention in precision medicine with artificial intelligence. While the heterogeneous presentation of cervical lymphadenopathy in locally advanced NPC is regarded as the same clinical stage under TNM criteria, radiomic analysis provides more insights into risk stratification, treatment differentiation, and survival prediction. There appears to be a lack of a review that consolidates radiomics-related studies on lymph node metastasis in NPC. The aim of this paper is to summarize the state-of-the-art of radiomics for lymph node analysis in NPC, including its potential use in prognostic prediction, treatment response, and overall survival for this cohort of patients.