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• Clinical Article •
Dynamic contrast-enhanced MRI early predicts short-term control of nasopharyngeal carcinoma treated with neoadjuvant chemotherapy followed by intensity-modulated radiotherapy
ZHENG De-chun  LIU Meng  YUE Qiu-yuan  LIN Hao  ZHANG Xiao-xiao  LAI Guo-jing  LIU Xiang-yi  CHEN Yun-bin 

DOI:10.12015/issn.1674-8034.2017.03.007.


[Abstract] Objective: To investigate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) in assessing short-term control of chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC).Materials and Methods: MRI and clinical materials of local advanced NPC patients (n=87) who were scheduled for neoadjuvant chemotherapy (NAC) following by aggressive intensity-modulated radiation therapy (IMRT) were studied. DCE MRI was performed [before NAC and five fractions after IMRT (one week) treatment] and four kinetic parameters (Ktrans, Kep, Ve and Vp) based on extended Tofts model were measured. Comparisons were made between different clinical response groups during and after IMRT using independent-samples t test or Mann-Whitney U test.Results: Reductions of both Ktrans and Kep values early after one week IMRT were observed in patients who achieved well clinical response after NAC and IMRT treatment. Compared to residual disease (partial response, PR) patients after radical CRT, the pretreatment Ktrans value, percentage change and difference values of Ktrans and Kep parameters between pretreatment and after one week IMRT, and tumor regression ratio after one week IMRT were all significantly larger in complete response (CR) patients (P<0.05). According to receiver operating characteristic analyses, diagnosis efficacies of single Ktrans, △Ktrans, △Kep, Ktrans(Perc), and Kep(Perc) values ranged from 0.655-0.829, while combined tumor regression ratio with above kinetic parameters yielded the highest diagnosis efficacy, sensitivity, and equivalent specificity (0.832, 84.0%, 64.5%, respectively).Conclusions: DCE MRI has the potential to predict short-term control of local advanced toward chemoradiotherapy.
[Keywords] Nasopharyngeal neoplasms；Magnetic resonance imaging；Image enhancement；Comparative effectiveness research

ZHENG De-chun* Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

LIU Meng Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

YUE Qiu-yuan Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

LIN Hao Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

ZHANG Xiao-xiao Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

LAI Guo-jing Department of Radiation Therapy Center, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

LIU Xiang-yi Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

CHEN Yun-bin Department of Radiology, Fujian Provincial Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China

*Correspondence to: Zheng DC, E-mail: Dechun.zheng@139.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This study is partly supported by the Natural Science Foundation of Fujian Province and partly supported by the National Clinical Key Specialty Construction Program and Key Clinical Specialty Discipline Construction Program of Fujian No. 2012J01330
Received  2016-11-29
Accepted  2017-01-10
DOI: 10.12015/issn.1674-8034.2017.03.007
DOI:10.12015/issn.1674-8034.2017.03.007.

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