Pre-treatment intravoxel incoherent motion diffusion-weighted imaging predicts treatment outcome in nasopharyngeal carcinoma

Qamar, Sahrish; King, Ann D.; Ai, Qi Yong H.; So, Tiffany Y.; Mo, Frankie; Chen, Weitian; Poon, Darren M.C.; Tong, Macy; Brigette, B.; Hui, Edwin P.; Yeung, David W. K.; Wang, Yixiang; Yuan, Jing

doi:10.1016/j.ejrad.2020.109127

Cited by 21 publications

(33 citation statements)

References 37 publications

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“…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 .…”

Section: Resultsmentioning

confidence: 99%

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

Lee

Choi

Jung

2021

Sci Rep

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Early prediction of treatment response in nasopharyngeal carcinoma is clinically relevant for optimizing treatment strategies. This meta-analysis was performed to evaluate whether apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) can predict treatment response of patients with nasopharyngeal carcinoma. A systematic search of PubMed-MEDLINE and Embase was performed to identify relevant original articles until July 22, 2021. We included studies which performed DWI for predicting locoregional treatment response in nasopharyngeal carcinoma treated with neoadjuvant chemotherapy, definitive chemoradiation, or radiation therapy. Hazard ratios were meta-analytically pooled using a random-effects model for the pooled estimates of overall survival, local relapse-free survival, distant metastasis-free survival and their 95% CIs. ADC showed a pooled sensitivity of 87% (95% CI 72–94%) and specificity of 70% (95% CI 56–80%) for predicting treatment response. Significant between-study heterogeneity was observed for both pooled sensitivity (I2 = 68.5%) and specificity (I2 = 92.2%) (P < 0.01). The pooled hazard ratios of low pretreatment ADC for assessing overall survival, local relapse-free survival, and distant metastasis-free survival were 1.42 (95% CI 1.09–1.85), 2.31 (95% CI 1.42–3.74), and 1.35 (95% CI 1.05–1.74), respectively. In patients with nasopharyngeal carcinoma, pretreatment ADC demonstrated good predictive performance for treatment response.

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Section: Resultsmentioning

confidence: 99%

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

Lee

Choi

Jung

2021

Sci Rep

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“…IVIM MRI technique can characterize tumor heterogeneity and is increasingly being applied in prediction of therapeutic efficacy in HNSCC patients. Recently, some previous studies demonstrated that pretreatment D value was a good predictor of treatment response or prognosis in HNSCC patients 35–37 . Compared to the nonresponders, the responders exhibited lower baseline D value, which reflects higher cellularity and more restricted diffusion of the tumor.…”

Section: Discussionmentioning

confidence: 98%

“…Recently, some previous studies demonstrated that pretreatment D value was a good predictor of treatment response or prognosis in HNSCC patients. [35][36][37] Compared to the nonresponders, the responders exhibited lower baseline D value, which reflects higher cellularity and more restricted diffusion of the tumor. Tumor cell density in highly proliferating state in solid tumor may closely related to chemosensitivity.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model‐Free Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Guo

Ouyang

et al. 2021

Magnetic Resonance Imaging

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Background: Multiparametric intravoxel incoherent motion (IVIM) provides diffusion and perfusion information for the treatment prediction of cancer. However, the superiority of IVIM over dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in locally advanced hypopharyngeal carcinoma (LAHC) remains unclear. Purpose: To compare the diagnostic performance of IVIM and model-free DCE in assessing induction chemotherapy (IC) response in patients with LAHC. Study Type: Prospective. Population: Forty-two patients with LAHC. Field Strength/Sequence: 3.0 T MRI, including IVIM (12 b values, 0-800 seconds/mm 2 ) with a single-shot echo planar imaging sequence and DCE-MRI with a volumetric interpolated breath-hold examination sequence. IVIM MRI is a commercially available sequence and software for calculation and analysis from vendor. Assessment: The IVIM-derived parameters (diffusion coefficient [D], pseudodiffusion coefficient [D*], and perfusion fraction [f]) and DCE-derived model-free parameters (Wash-in, time to maximum enhancement [Tmax], maximum enhancement [Emax], area under enhancement curve [AUC] over 60 seconds [AUC 60 ], and whole area under enhancement curve [AUC w ]) were measured. At the end of IC, patients with complete or partial response were classified as responders according to the Response Evaluation Criteria in Solid Tumors.Statistical Tests: The differences of parameters between responders and nonresponders were assessed using Mann-Whitney U tests. The performance of parameters for predicting IC response was evaluated by the receiver operating characteristic curves. Results: Twenty-three (54.8%) patients were classified as responders. Compared with nonresponders, the perfusion parameters D*, f, f × D*, and AUC w were significantly higher whereas Wash-in was lower in responders (all P-values <0.05). The f × D* outperformed other parameters, with an AUC of 0.84 (95% confidence interval [CI]: 0.69-0.93), sensitivity of 79.0% (95% CI: 54.4-93.9), and specificity of 82.6% (95% CI: 61.2-95.0).

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“…Challenging fields of research could be not only the decrease of toxicity and the patient selection, but also the development of more advanced hardware, e.g., allowing for VMAT, or software, e.g., for monitor unit verification (66). Finally, the possibility to have access to daily, repetitive imaging during the whole course of radiotherapy could open completely new dimensions with respect to both functional imaging, like diffusion-weighted-MRI (80,81), and radiomics (82) for predicting tumor response and normal tissue toxicity. This aspect becomes even more interesting through the possibility of comparison of high-(1.5 T) and low-field (0.35 T) magnetic resonance imaging provided by the different platforms.…”

Section: Discussionmentioning

confidence: 99%

MR-Guided Radiotherapy for Head and Neck Cancer: Current Developments, Perspectives, and Challenges

et al. 2021

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Based on the development of new hybrid machines consisting of an MRI and a linear accelerator, magnetic resonance image guided radiotherapy (MRgRT) has revolutionized the field of adaptive treatment in recent years. Although an increasing number of studies have been published, investigating technical and clinical aspects of this technique for various indications, utilizations of MRgRT for adaptive treatment of head and neck cancer (HNC) remains in its infancy. Yet, the possible benefits of this novel technology for HNC patients, allowing for better soft-tissue delineation, intra- and interfractional treatment monitoring and more frequent plan adaptations appear more than obvious. At the same time, new technical, clinical, and logistic challenges emerge. The purpose of this article is to summarize and discuss the rationale, recent developments, and future perspectives of this promising radiotherapy modality for treating HNC.

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Pre-treatment intravoxel incoherent motion diffusion-weighted imaging predicts treatment outcome in nasopharyngeal carcinoma

Cited by 21 publications

References 37 publications

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

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

Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model‐Free Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

MR-Guided Radiotherapy for Head and Neck Cancer: Current Developments, Perspectives, and Challenges

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