Arterial spin labeling of nasopharyngeal carcinoma shows early therapy response

Objective This study aimed to determine the value of arterial spin labeling (ASL) perfusion imaging in assessing the early efficacy of chemoradiotherapy for nasopharyngeal carcinoma (NPC). Methods Fifty-five patients with locoregionally advanced NPC underwent conventional 3.0-T magnetic resonance imaging (MRI) and ASL before and after chemoradiotherapy (prescribed dose reached 40 Gy). Based on the response evaluation criteria for solid tumors (RECIST 1.1), the patients were divided into the partial response and stable disease groups. MRI re-examination was performed one month after chemoradiotherapy completion, and patients were divided into residual and non-residual groups. We investigated inter-group differences in ASL-based tumor blood flow (TBF) parameters (pre-treatment tumor blood flow, post-treatment tumor blood flow, and changes in tumor blood flow, i.e., Pre-TBF, Post-TBF, Delta TBF), correlation between TBF parameters and tumor atrophy rate, and value of TBF parameters in predicting sensitivity to chemoradiotherapy. Results There were differences in Pre-TBF, Post-TBF, and Delta TBF between the partial response and stable disease groups (p < 0.01). There were also differences in Pre-TBF and Delta TBF between the residual and non-residual groups (p < 0.01). Pre-TBF and Delta TBF were significantly correlated with the tumor atrophy rate; the correlation coefficients were 0.677 and 0.567, respectively (p < 0.01). Pre-TBF had high diagnostic efficacies in predicting sensitivity to chemoradiotherapy and residual tumors, with areas under the curve of 0.845 and 0.831, respectively. Conclusion ASL permits a noninvasive approach to predicting the early efficacy of chemoradiotherapy for NPC.

Automated summary

This study demonstrates the value of arterial spin labeling (ASL) perfusion imaging in assessing the early efficacy of chemoradiotherapy for nasopharyngeal carcinoma (NPC). By investigating tumor blood flow parameters and their correlation with tumor atrophy rate, it is possible to predict the sensitivity to chemoradiotherapy and the presence of residual tumors.