Diffusion-kurtosis imaging predicts early radiotherapy response in nasopharyngeal carcinoma patients
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Gang Wu1,*, Meng-Meng Li2,*, Feng Chen3, Shao-Ming Lin1, Kai Yang3, Ying-Man Zhao3, Xiao-Lei Zhu4, Wei-Yuan Huang3 and Jian-Jun Li3
1Department of Radiotherapy, Hainan General Hospital, Hainan, China
2Research and Education Department, Hainan General Hospital, Hainan, China
3Department of Radiology, Hainan General Hospital, Hainan, China
4Siemens Healthcare, MR Scientific Marketing NE Asia, Beijing, China
*These authors have contributed equally to this work
Wei-Yuan Huang, email: [email protected]
Jian-Jun Li, email: [email protected]
Keywords: diffusion-kurtosis imaging, DKI; magnetic romance imaging, MRI; nasopharyngeal carcinoma, NPC; radiotherapy
Received: February 13, 2017 Accepted: June 28, 2017 Published: August 02, 2017
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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