Pre-treatment intravoxel incoherent motion diffusion-weighted imaging predicts treatment outcome in nasopharyngeal carcinoma
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AbstractPurpose: To evaluate whether pre-treatment intravoxel incoherent motion diffusion-weighted imaging (IVIMDWI) can predict treatment outcome after 2 years in patients with nasopharyngeal carcinoma (NPC).
Method: One hundred and sixty-one patients with newly diagnosed NPC underwent pre-treatment IVIM-DWI. Univariate Cox regression analysis was performed to evaluate the correlation of the mean values of the pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction and apparent diffusion coefficient with local relapse-free survival (LRFS), regional relapse-free survival (RRFS), distant metastases-free survival (DMFS) and disease-free survival (DFS). Significant diffusion parameters, together with staging, age, gender and treatment as confounding factors, were added into a multivariate model. The area under the curves (AUCs) of significant parameters for disease relapse were compared using the Delong test.
Results: Disease relapse occurred in 30 % of the patients at a median follow-up time of 52.1 months. The multivariate analysis showed that high D and T-staging were correlated with poor LRFS (p = 0.042 and 0.020, respectively) and poor DFS (p = 0.023 and 0.001, respectively); low D* and high T-staging with poor RRFS (p = 0.020 and 0.033, respectively); and high N-staging with poor DMFS (p = 0.006). D with the optimal threshold of ≥0.68 × 10−3 mm2/s and T-staging showed similar AUCs (AUC = 0.614 and 0.651, respectively; p = 0.493) for predicting disease relapse.
Conclusion: High D and low D* were predictors of poor locoregional outcome but none of the diffusion parameters predicted DMFS in NPC.
Acceptance Date07/06/2020
All Author(s) ListSahrish Qamar, Ann D. King, Qi-Yong H Ai, Tiffany Y. So, Frankie Kwok Fai Mo, Weitian Chen, Darren M.C. Poon, Macy Tong, Brigette B. Ma, Edwin P. Hui, David Ka-Wai Yeung, Yi-Xiang Wang, Jing Yuan
Journal nameEuropean Journal of Radiology
Year2020
Month8
Volume Number129
PublisherElsevier
Article number109127
ISSN0720-048X
eISSN1872-7727
LanguagesEnglish-United States
KeywordsIntravoxel incoherent motion, Diffusion-weighted imaging, Nasopharyngeal carcinoma, Head and neck cancer, Survival, Treatment outcome

Last updated on 2020-23-10 at 00:35