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Radiol Med. 2018 Jan;123(1):36-43. doi: 10.1007/s11547-017-0808-9. Epub 2017 Sep 15.

Heterogeneity analysis of diffusion-weighted MRI for prediction and assessment of microstructural changes early after one cycle of induction chemotherapy in nasopharyngeal cancer patients.

Author information

1
Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Institute for Advanced Medical Imaging, Tehran University of Medical Sciences, Tehran, Iran.
2
Department of Biostatistics, Shiraz University of Medical Science, Shiraz, Iran.
3
Payambaran Imaging Center, Tehran, Iran.
4
Department of Clinical Oncology, ShahidBeheshti University of Medical Science, Tehran, Iran.
5
Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
6
Department of Clinical Oncology, ShahidBeheshti University of Medical Science, Tehran, Iran. a_ameri@sbmu.ac.ir.

Abstract

PURPOSE:

To evaluate whether the pretreatment apparent diffusion coefficient (ADC) heterogeneity parameters and their alterations, after one cycle of induction chemotherapy, can be used as reliable markers of treatment response to induction chemotherapy in patients with nasopharyngeal cancer.

MATERIALS AND METHODS:

Ten patients were recruited and received induction chemotherapy (IC). Diffusion-weighted imaging was performed prior to, during, and after IC. The first-order ADC histogram parameters at the intra-treatment time-point were compared to the baseline time-point in the metastatic lymph nodes (LNs). Some ADC pretreatment parameters were combined with each other, employing discriminant analysis to achieve a feasible model to separate the complete response (CR) from the partial response (PR) groups.

RESULTS:

For ten patients, significant rise in Mean and Txt1Mean (p = 0.048 and 0.015, respectively) was observed in the metastatic nodes following one cycle of IC. Txt5Energy significantly decreased (p = 0.002). Discriminant analysis on pretreatment parameters illustrated that Txt5Energypre was the best parameter to use to correctly classify CR and PR patients. This was followed by Txt9Percentile75pre, Txt1Meanpre, and Txt2Standard Deviationpre.

CONCLUSIONS:

Our results suggest that heterogeneity metrics extracted from ADC-maps in metastatic lymph nodes, before and after IC, can be used as supplementary IC response indicators.

KEYWORDS:

Diffusion-weighted MRI; Induction chemotherapy; Lymph node; Nasopharyngeal cancer

PMID:
28914416
DOI:
10.1007/s11547-017-0808-9
[Indexed for MEDLINE]

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