Early response to chemoradiotherapy for nasopharyngeal carcinoma treatment: Value of dynamic contrast‐enhanced 3.0 T MRI. Issue 6 (18th August 2014)

• Record Type: Journal Article
• Authors: Zheng, Dechun; Chen, Yunbin; Liu, Xiangyi; Chen, Ying; Xu, Luying; Ren, Wang; Chen, Weibo; Chan, Queenie
• Is Part Of: Journal of magnetic resonance imaging. Volume 41:Issue 6(2015)
• Page Start: 1528
• Page End: 1540
• Publication Date: 2014-08-18
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.24723
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri24723-sec-0001" sec-type="section"> <title>Purpose</title> <p>To prospectively evaluate the dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) value for predicting early nasopharyngeal carcinoma (NPC) chemoradiotherapy (CRT) response.</p> </sec> <sec id="jmri24723-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>Forty‐two patients with advanced NPC were recruited and received three DCE‐MRI exams before treatment (Pre‐Tx), as well as 3 days (Day 3‐Tx) and 40 days (Day 40‐Tx) after chemotherapy initiation (two neoadjuvant chemotherapy cycles, NAC). We used DCE‐Tool to measure primary tumor kinetic parameters (<italic>K</italic><sup>trans</sup>, <italic>K</italic><sub>ep</sub>, <italic>v</italic><sub>e</sub>, and <italic>v</italic><sub>p</sub>) using the extended Tofts model. Kinetic parameters and corresponding changes were compared between responders and nonresponders after NAC or CRT treatment using Student's <italic>t</italic> or Mann–Whitney <italic>U</italic> tests.</p> </sec> <sec id="jmri24723-sec-0003" sec-type="section"> <title>Results</title> <p>Response to two NAC cycles correlated with short‐term local control (<italic>P</italic> = 0.01). Compared to the nonresponder group, the responder group presented with significantly larger Δ<italic>K</italic><sup>trans</sup><sub>(0–3)</sub>, Δ<italic>K</italic><sub>ep(0–3)</sub>, and Δ<italic>v</italic><sub>p(0–3)</sub> values after NAC (<italic>P</italic> < 0.05). The complete response group after CRT exhibited significantly lower <italic>K</italic><sup>trans</sup><sub>(Day 40‐Tx)</sub> and larger Δ<italic>K</italic><sup>trans</sup><sub>(0–3)</sub> values than the residual group (<italic>P</italic> = 0.05). High sensitivity (range: 74.1%–90%) and moderate‐to‐high specificity (range: 50%–84.3%) distinguished nonresponders from responders grouping after NAC or CRT, with diagnostic efficiency ranging from 69.3%–88%.</p> </sec> <sec id="jmri24723-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our study showed kinetic parameter changes earlier after chemotherapy were potential markers for NPC patients receiving CRT therapy following NAC. <bold>J. Magn. Reson. Imaging 2015;41:1528–1540</bold>. © <bold>2014 Wiley Periodicals, Inc</bold>.</p> </sec> </abstract>