磁共振成像2017，Vol.8Issue(3)：196-203,8.DOI:10.12015/issn.1674-8034.2017.03.007
探讨DCE-MRI早期预测鼻咽癌新辅助化疗和调强放疗疗效的价值
Dynamic contrast-enhanced MRI early predicts short-term control of nasopharyngeal carcinoma treated with neoadjuvant chemotherapy followed by intensity-modulated radiotherapy
摘要
Abstract
Objective:To investigate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) in assessing short-term control of chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC).Materials and Methods:MRI and clinical materials of local advanced NPC patients (n=87) who were scheduled for neoadjuvant chemotherapy (NAC) following by aggressive intensity-modulated radiation therapy (IMRT) were studied. DCE MRI was performed [before NAC and five fractions after IMRT (one week) treatment] and four kinetic parameters (Ktrans, Kep, Ve and Vp) based on extended Tofts model were measured. Comparisons were made between different clinical response groups during and after IMRT using independent-samplest test or Mann-Whitney U test.Results:Reductions of both Ktrans and Kep values early after one week IMRT were observed in patients who achieved well clinical response after NAC and IMRT treatment. Compared to residual disease (partial response, PR) patients after radical CRT, the pretreatment Ktrans value, percentage change and difference values of Ktrans and Kep parameters between pretreatment and after one week IMRT, and tumorregression ratio after one week IMRT were all significantly larger in complete response (CR) patients (P<0.05). According to receiver operating characteristic analyses, diagnosis efficacies of single Ktrans,△Ktrans,△Kep, Ktrans(Perc), and Kep(Perc) values ranged from 0.655—0.829, while combined tumor regression ratio with above kinetic parameters yielded the highest diagnosis efficacy, sensitivity, and equivalent specificity (0.832, 84.0%, 64.5%, respectively).Conclusions:DCE MRI has the potential to predict short-term control of local advanced toward chemoradiotherapy.关键词
鼻咽肿瘤/磁共振成像/图像增强/疗效比较研究Key words
Nasopharyngeal neoplasms/Magnetic resonance imaging/Image enhancement/Comparative effectiveness research分类
医药卫生引用本文复制引用
郑德春,刘萌,岳秋圆,林浩,张潇潇,赖国静,刘向一,陈韵彬..探讨DCE-MRI早期预测鼻咽癌新辅助化疗和调强放疗疗效的价值[J].磁共振成像,2017,8(3):196-203,8.基金项目
福建省自然基金项目、国家临床重点专科建设项目和福建省临床重点专科建设项目(编号:2012J01330) ACKNOWLEDGMENTS This study is partly supported by the Natural Science Foundation of Fujian Province and partly supported by the National Clinical Key Specialty Construction Program and Key Clinical Specialty Discipline Construction Program of Fujian (No. 2012J01330). （编号:2012J01330）
