Journal
JOURNAL OF MAGNETIC RESONANCE IMAGING
Volume 42, Issue 5, Pages 1354-1361Publisher
WILEY
DOI: 10.1002/jmri.24910
Keywords
diffusion-weighted MRI; diffusion kurtosis imaging; treatment monitoring; nasopharyngeal carcinoma; neoadjuvant chemotherapy
Funding
- Social development guidance projects of Fujian Province [2014Y0013]
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PurposeTo explore the clinical value of diffusion kurtosis imaging (DKI) and monoexponential diffusion-weighted imaging (DWI) for predicting early response to neoadjuvant chemotherapy (NAC) in patients with nasopharyngeal carcinoma (NPC). Materials and MethodsFifty-nine patients with stage III-IVb NPC underwent four 3.0T MR scans: prior to, and on the 4th, 21st, 42nd days after NAC initiation. The parameters of DKI (corrected diffusion coefficient, D; excess diffusion kurtosis coefficient, K) and monoexponential DWI (apparent diffusion coefficient, ADC) were obtained at the first three scans. Statistical methods included Student's t-test or Mann-Whitney U-test, receiver operating characteristic (ROC) curve analyses and paired X-2 test. ResultsD((pre)) in responders group (RG) was significantly lower than nonresponders group (NRG) (1.0290.033 vs. 1.184 +/- 0.055, x10(-3) mm(2)/s, P=0.020). ADC((day4)) and D-(day4) were the most useful parameters of the two diffusional models to distinguish RG from NRG, respectively (area under the curve, 0.761 vs. 0.895). D-(day4) was more sensitive than ADC((day4)) to predict treatment response to NAC (P=0.006). ConclusionBoth DKI and monoexponential DWI showed potential to predict treatment response to NAC prior to morphological change. DKI may be superior to monoexponential DWI for predicting early response to NAC in patients with locally advanced NPC. J. Magn. Reson. Imaging 2015;42:1354-1361.
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