Intratumoral and Peritumoral Habitat Radiomics of MRI Predict Pathologic Complete Response to Neoadjuvant Chemoimmunotherapy in Oral Squamous Cell Carcinoma

Background：Neoadjuvant chemoimmunotherapy (NACI) shows promise in oral squamous cell carcinoma (OSCC), but reliable noninvasive biomarkers for predicting pathologic complete response (pCR) remain scarce. Radiomics integrating intratumoral and peritumoral heterogeneity across multi-sequence MRI may offer novel insights into treatment response evaluation. Methods: The data of 212 patients with OSCC after NACI were retrospectively collected and analyzed. Among these patients, 56 (26.4%) achieved pCR after NACI. Intratumoral and peritumoral habitat imaging (HI) was achieved using the K-means clustering algorithm applied to T1-weighted imaging (T1WI), axial T2-weighted imaging with fat suppression (T2WI), and contrast-enhanced T1-weighted imaging with fat suppression (T1C). Moreover, intratumoral and peritumoral HI models were constructed and compared using the receiver operating characteristic (ROC) curve. Five-fold cross-validation was performed to mitigate model overfitting.

Sex

All

Inclusion Criteria:

* Histopathologically confirmed OSCC at the initial diagnosis;
* No treatment received prior to the first MRI examination;
* Receipt of NACI;
* Underwent MRI examination after NACI;
* Underwent surgical intervention.

Exclusion Criteria:

* Absence of clinical data and postoperative pathological results;
* MRI image artifacts significantly affecting image quality.

• BACKGROUNDVaidya P, Bera K, Patil PD, Gupta A, Jain P, Alilou M, Khorrami M, Velcheti V, Madabhushi A. Novel, non-invasive imaging approach to identify patients with advanced non-small cell lung cancer at risk of hyperprogressive disease with immune checkpoint blockade. J Immunother Cancer. 2020 Oct;8(2):e001343. doi: 10.1136/jitc-2020-001343. PMID 33051342
• BACKGROUNDTunali I, Hall LO, Napel S, Cherezov D, Guvenis A, Gillies RJ, Schabath MB. Stability and reproducibility of computed tomography radiomic features extracted from peritumoral regions of lung cancer lesions. Med Phys. 2019 Nov;46(11):5075-5085. doi: 10.1002/mp.13808. Epub 2019 Sep 23. PMID 31494946
• BACKGROUNDWang CY, Ginat DT. Preliminary Computed Tomography Radiomics Model for Predicting Pretreatment CD8+ T-Cell Infiltration Status for Primary Head and Neck Squamous Cell Carcinoma. J Comput Assist Tomogr. 2021 Jul-Aug 01;45(4):629-636. doi: 10.1097/RCT.0000000000001149. PMID 34519454
• BACKGROUNDWang C, Wu F, Wang F, Chong HH, Sun H, Huang P, Xiao Y, Yang C, Zeng M. The Association Between Tumor Radiomic Analysis and Peritumor Habitat-Derived Radiomic Analysis on Gadoxetate Disodium-Enhanced MRI With Microvascular Invasion in Hepatocellular Carcinoma. J Magn Reson Imaging. 2025 Mar;61(3):1428-1439. doi: 10.1002/jmri.29523. Epub 2024 Jul 12. PMID 38997242
• BACKGROUNDShang Y, Chen W, Li G, Huang Y, Wang Y, Kui X, Li M, Zheng H, Zhao W, Liu J. Computed Tomography-derived intratumoral and peritumoral radiomics in predicting EGFR mutation in lung adenocarcinoma. Radiol Med. 2023 Dec;128(12):1483-1496. doi: 10.1007/s11547-023-01722-6. Epub 2023 Sep 25. PMID 37749461
• BACKGROUNDShang Y, Zeng Y, Luo S, Wang Y, Yao J, Li M, Li X, Kui X, Wu H, Fan K, Li ZC, Zheng H, Li G, Liu J, Zhao W. Habitat Imaging With Tumoral and Peritumoral Radiomics for Prediction of Lung Adenocarcinoma Invasiveness on Preoperative Chest CT: A Multicenter Study. AJR Am J Roentgenol. 2024 Oct;223(4):e2431675. doi: 10.2214/AJR.24.31675. Epub 2024 Aug 14.