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

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.

Diffusion-weighted MRI for predicting treatment response in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis

“…After screening the titles and abstracts, 22 articles were considered potentially eligible after excluding 108 articles for the following reasons: non-English articles (n = 22), case reports (n = 9), not in the field of interest (n = 56), non-original articles (i.e., reviews, letters, editorials, conference abstracts) (n = 18), and non-human studies (n = 3). After full-text review, nine articles were further excluded because they were not in the field of interest (n = 1) 28 , had overlapping study populations (n = 2) 10 , 29 , had insufficient information for the reconstruction of 2 × 2 tables (n = 1) 30 , insufficient detail of pretreatment ADC (n = 3) 31 – 33 , or region of interest was on lymph nodes only (n = 2) 34 , 35 . Thirteen original studies were included for qualitative synthesis 5 , 6 , 8 , 9 , 11 – 19 .…”

Value of Apparent Diffusion Coefficient Histogram Analysis in the Differential Diagnosis of Nasopharyngeal Lymphoma and Nasopharyngeal Carcinoma Based on Readout-Segmented Diffusion-Weighted Imaging

“…However, since SS-EPI is susceptible to magnetic susceptibility artifacts, its image quality has not always been satisfying (9). Furthermore, few studies (22,23) have reported the application of RESOLVE-DWI for nasopharynx tumors, as well as the discrimination of NPL and NPC. In the present study, the ADC maps used for the histogram analysis were obtained using the RESOLVE sequence.…”

Early Stage Markers of Late Delayed Neurocognitive Decline Using Diffusion Kurtosis Imaging of Temporal Lobe in Nasopharyngeal Carcinoma Patients

“…DKI-derived kurtosis and diffusion metrics are powerful indicators of microstructural information in the brain. DKI has been successfully used to evaluate aging, attention deficit hyperactivity disorder, cerebral glioma, epilepsy, and head and neck cancer in vivo, and has been shown to capture diffusion and kurtosis alterations especially well in white matter 12,13 .…”