Open AccessDiffusion-kurtosis imaging predicts early radiotherapy response in nasopharyngeal carcinoma patients
Author(s) -
Gang Wu,
Mengmeng Li,
Feng Chen,
Shao-Ming Lin,
Kai Yang,
Zhao Ying-man,
Xiaolei Zhu,
Weiyuan Huang,
Jianjun Li
Publication year - 2017
Publication title -
oncotarget
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.373
H-Index - 127
ISSN - 1949-2553
DOI - 10.18632/oncotarget.19820
Subject(s) - nasopharyngeal carcinoma , medicine , radiation therapy , kurtosis , effective diffusion coefficient , receiver operating characteristic , diffusion mri , magnetic resonance imaging , nuclear medicine , oncology , radiology , statistics , mathematics
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 (D axis , D mean and D rad ) 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 (K axis , K fa , K mean , K rad 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 K rad coefficient (0.76) was the best parameter to predict the radiotherapy response. Based on receiver operating characteristic curve analysis K rad 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.