Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Law, Benjamin King Hong; King, Ann D.; Bhatia, Kunwar S.; Ahuja, Anil T.; Kam, Michael K.M.; B.Y., Brigette; Ai, Qi Yong H.; Mo, Frankie; Yuan, Jing; Yeung, D.

doi:10.3174/ajnr.a4792

Cited by 33 publications

(29 citation statements)

References 41 publications

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“…As a useful MRI functional sequence, DWI provides functional and structural information on the microanatomy in tissues, which plays a signi cant role in routine MRI examination and serves as a good supplement to improve the accuracy of assessing the properties and biological behaviors of nasopharyngeal carcinoma. Meanwhile, ADC value derived from DWI has been shown to have potential as imaging bio-markers for predicting the histopathological grade and indicating the aggressiveness of nasopharyngeal carcinoma [12,22]. In this study, the mean ADC value of responders was signi cantly higher than that of non-responders, which were consistent with those of previous research [23,24].…”

Section: Discussionsupporting

confidence: 90%

High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

Meng

Wang

Liu

et al. 2020

Preprint

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Background To evaluate the feasibility of high resolution diffusion weighted imaging (DWI) for the prediction about the response of neoadjuvant chemotherapy (NAC) in patients. Methods 119 NPC patients who underwent magnetic resonance imaging (MRI) including readout-segmented diffusion weighted imaging (RESOLVE-DWI) before treatment enrolled in this study from September 2017 to December 2019, and all patients underwent follow-up MRI at 3 month after two cycles of NAC. Patients were classified into stable disease (SD), partial response (PR) or completed response (CR) based on Response Evaluation Criteria in Solid Tumors (RECIST). Apparent diffusion coefficient (ADC) values were measured from RESOLVE-DWI in the first MRI examination. The ADC values were compared between responders (CR and PR) and non-responders (SD) using Independent samples t-test, and the receiver operating characteristic curve (ROC) was calculated to assess the diagnostic efficacy. Results The ADC value of responders was significantly higher than that of non-responders (719.73 ± 100.44 × 10− 3 mm2/s and 583.28 ± 53.15 × 10− 3 mm2/s, p < 0.001, respectively). The area under the curve (AUC) was 0.879 with a sensitivity at 82.8%, and specificity at 84.6%. Conclusions The ADC value obtained by RESOLVE-DWI, with a high diagnostic accuracy for NAC assessment, could be used as a pretreatment imaging biomarker to predict the early response to NAC in NPC patients.

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Section: Discussionsupporting

confidence: 90%

High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

Meng

Wang

Liu

et al. 2020

Preprint

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“…The apparent diffusion coefficient (ADC) for predicting local outcomes for NPC patients have been described previously [ 5 , 23 , 24 ]. Also, the DTI or DKI parameters for predicting treatment outcomes in head and neck lesions have been described in previous studies [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…It would help clinicians to shift to personalized medicine and avoid unnecessary systemic toxicity for NPC patients. Prospective studies have used diffusion-weighted imaging (DWI) pre-treatment to analyze treatment response in head and neck tumors [ 5 – 9 ]. The mono-exponential DWI analyzes in vivo water diffusion based on standard Gaussian distribution [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-kurtosis imaging predicts early radiotherapy response in nasopharyngeal carcinoma patients

Chen

et al. 2017

Oncotarget

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In this prospective study, we analyzed diffusion kurtosis imaging (DKI) parameters to predict the early response to radiotherapy in 23 nasopharyngeal carcinoma (NPC) patients. All patients underwent conventional magnetic resonance imaging (MRI) and DKI before and after radiotherapy. The patients were divided into response (RG; no residual tumors; 16/23 patients) and no-response (NRG; residual tumors; 7/23 patients) groups, based on MRI and biopsy results 3 months after radiotherapy. The maximum diameter of tumors in RG and NRG patients were similar prior to radiotherapy (p=0.103). The pretreatment diffusion coefficient (D) parameters (Daxis, Dmean and Drad) were higher in RG than NRG patients (p=0.022, p=0.027 and p=0.027). Conversely, the pre-treatment fractional anisotropy (FA) and kurtosis coefficient (K) parameters (Kaxis, Kfa, Kmean, Krad and Mkt) were lower in RG than NRG patients (p=0.015, p=0.022, p=0.008, p=0.004, p=0.001, p=0.002). The Krad coefficient (0.76) was the best parameter to predict the radiotherapy response. Based on receiver operating characteristic curve analysis Krad showed 71.4% sensitivity and 93.7% specificity (AUC: 0.897, 95% CI, 0.756-1). Multivariate analysis indicated DKI parameters were independent prognostic factors for the short-term effect in NPC. Thus, DKI predicts the early response to radiotherapy in NPC patients.

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“…Numerous studies have shown the potential of 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography (FDG-PET) alone or hybrid PET/CT, in evaluating residual/recurrent head and neck tumors[14,18]. However, PET results are confounded by the local inflammation post treatment, especially in early post treatment phase in nasopharyngeal cancers[19,20]. Post treatment surveillance is routinely done by morphological imaging techniques like CT/MRI.…”

Section: Applications Of Dwi In Oncologymentioning

confidence: 99%

“…DWI has proved to be a useful biomarker for assessing treatment response in head and neck cancer. Pretreatment primary tumor SUV (max) and ADC values have been shown to correlate significantly and negatively with a potential to predict disease free survival or disease events of head and neck squamous cell carcinoma[20-23]. Role of DWI imaging has also been explored in characterizing thyroid lesions and initial results suggests that combined multimodality MRI, ultrasound and PET imaging has significant role to play in indeterminate thyroid lesions especially the Bethesda category-III[24-26].…”

Section: Applications Of Dwi In Oncologymentioning

confidence: 99%

Diffusion magnetic resonance imaging: A molecular imaging tool caught between hope, hype and the real world of “personalized oncology”

Mahajan

Deshpande

Thakur

2017

WJR

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“Personalized oncology” is a multi-disciplinary science, which requires inputs from various streams for optimal patient management. Humongous progress in the treatment modalities available and the increasing need to provide functional information in addition to the morphological data; has led to leaping progress in the field of imaging. Magnetic resonance imaging has undergone tremendous progress with various newer MR techniques providing vital functional information and is becoming the cornerstone of “radiomics/radiogenomics”. Diffusion-weighted imaging is one such technique which capitalizes on the tendency of water protons to diffuse randomly in a given system. This technique has revolutionized oncological imaging, by giving vital qualitative and quantitative information regarding tumor biology which helps in detection, characterization and post treatment surveillance of the lesions and challenging the notion that “one size fits all”. It has been applied at various sites with different clinical experience. We hereby present a brief review of this novel functional imaging tool, with its application in “personalized oncology”.

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Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Cited by 33 publications

References 41 publications

High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

Diffusion-kurtosis imaging predicts early radiotherapy response in nasopharyngeal carcinoma patients

Diffusion magnetic resonance imaging: A molecular imaging tool caught between hope, hype and the real world of “personalized oncology”

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