Breaking the shackles of morphology: a novel perspective on immunotherapy evaluation for nasopharyngeal carcinoma using multimodal imaging and radiomics – a review

Nasopharyngeal carcinoma is a highly aggressive malignant tumor, and research into its immunotherapy has attracted considerable attention in recent years. Imaging assessment plays a pivotal role in monitoring the efficacy of immunotherapy. Traditional evaluation methods are becoming increasingly limited in clinical applicability because of their inability to capture the spatiotemporal heterogeneity of immunotherapy responses. In this context, the development of multimodal fusion imaging techniques, radiomics, and novel probes offers new perspectives to address these challenges. These advanced and emerging technologies not only provide more comprehensive and precise anatomical, functional, and metabolic information but also enable multidimensional and in-depth data mining and analysis, thereby optimizing immunotherapy response evaluation workflows and enhancing the accuracy of efficacy predictions. Future research should focus on establishing and standardizing novel assessment systems, developing and optimizing specific molecular probes, and integrating multiomics data to advance personalized therapeutic decision-making. This narrative review retrospectively summarizes the progress in imaging assessment for nasopharyngeal carcinoma immunotherapy, spanning from the limitations of conventional methods to the application of technological innovations, and ultimately identifying optimized pathways for clinical practice, with the goal of providing a reference for future research.