In Vivo Imaging Markers for Prediction of Radiotherapy Response in Patients with Nasopharyngeal Carcinoma: RESOLVE DWI versus DKI

Wei-Yuan Huang,Xiao-Lei Zhu,Feng Chen,Jian-Jun Li,Meng-Meng Li,Gang Wu,Shao-Min Lin,Kai Yang

doi:10.1038/s41598-018-34072-9

Wei-Yuan Huang, Xiao-Lei Zhu + Show 6 more

Open Access

https://doi.org/10.1038/s41598-018-34072-9

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Abstract

In this prospective study, we compared the performance of readout segmentation of long variable echo trains of diffusion-weighted imaging (RESOLVE DWI) and diffusion kurtosis imaging (DKI) for the prediction of radiotherapy response in patients with nasopharyngeal carcinoma (NPC). Forty-one patients with NPC were evaluated. All patients underwent conventional MRI, RESOLVE DWI and DKI, before and after radiotherapy. All patients underwent conventional MRI every 3 months until 1 year after radiotherapy. The patients were divided into response group (RG; 36/41 patients) and no-response group (NRG; 5/41 patients) based on follow-up results. DKI (the mean of kurtosis coefficient, Kmean and the mean of diffusion coefficient, Dmean) and RESOLVE DWI (the minimum apparent diffusion coefficient, ADCmin) parameters were calculated. Parameter values at the pre-treatment period, post-treatment period, and the percentage change between these 2 periods were obtained. All parameters differed between the RG and NRG groups except for the pretreatment Dmean and ADCmin. Kmean-post was considered as an independent predictor of local control, with 87.5% sensitivity and 91.3% specificity (optimal threshold = 0.30, AUC: 0.924; 95% CI, 0.83–1.00). Kmean-post values of DKI have the potential to be used as imaging biomarkers for the early evaluation of treatment effects of radiotherapy on NPC.

Highlights

MethodsThis study was performed at a single hospital from November 2014 until April 2017
Our preliminary study demonstrated that diffusion kurtosis imaging (DKI) could be a noninvasive tool to predict the early response to radiotherapy in nasopharyngeal carcinoma (NPC) patients[14]
Based on our preliminary study, we continue to collect patients. This preliminary study investigated the ability of both DKI and RESOLVE DWI at 3 T to assess early treatment responses to radiotherapy in NPC patients

Summary

Methods

This study was performed at a single hospital from November 2014 until April 2017. All procedures were approved by the Medical and Health Research Ethics Committee of Hainan General Hospital. All methods were performed in accordance with the national guidelines and regulations. Each patient signed an informed consent form after the nature of the procedure had been fully explained. TNM status was determined according to the seventh edition of the American Joint Committee on Cancer (AJCC) staging system[28]

Results

Discussion

Conclusion