RSNA 2014 

Abstract Archives of the RSNA, 2014


NRS432

Assessment of Response to Chemoradiotherapy for Nasopharyngeal Carcinoma: Value of Dynamic Contrast-Enhanced MR Imaging at 3 T

Scientific Posters

Presented on December 3, 2014
Presented as part of NRS-WEA: Neuroradiology Wednesday Poster Discussions

Participants

Chen Yunbin MD, Abstract Co-Author: Nothing to Disclose
Dechun Zheng MS, Presenter: Nothing to Disclose
Xiangyi Liu BS, Abstract Co-Author: Nothing to Disclose
Weibo Chen PhD, Abstract Co-Author: Nothing to Disclose
Queenie Chan PhD, Abstract Co-Author: Nothing to Disclose
Jin Lin, Abstract Co-Author: Nothing to Disclose
youping xiao, Abstract Co-Author: Nothing to Disclose
Wang Ren, Abstract Co-Author: Nothing to Disclose
Jianji Pan, Abstract Co-Author: Nothing to Disclose

PURPOSE

To prospectively investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to early predict chemoradiotherapy (CRT) response of nasopharyngeal carcinoma (NPC).

METHOD AND MATERIALS

Forty-two patients with advanced NPC scheduled for neoadjuvant chemotherapy (NAC) following by CRT were recruited and received three DCE-MRI exams before treatment (Pre-Tx), 3 days (Day3-Tx) and 40 days (Day40-Tx, at the end of two cycles of NAC) after chemotherapy initiation on 3T clinical scanner system (Achieva TX, Philips Healthcare). RECIST 1.1 criteria was applied to assess tumor response to NAC and CRT. After two cycles of NAC, both complete response (CR) and partial response (PR) patients were categorized into responders, and stable disease (SD) into non-responders. We used DCE-Tool (Philips Healthcare, Best, Netherlands) to measure kinetic parameters (Ktrans, Kep, ve, and vp) from primary tumors based on extended Tofts model. Kinetic parameters and their corresponding changes Δparameter(0-X) (X=3 or 40) were compared between responders and non-responders using student T or Mann-Whitney U test.

RESULTS

After two cycles of NAC, 27 of 41 patients were categorized into responders; and 31 of 41 into responders at the end of CRT. Response to NAC is correlated with short-term control (P=0.01). Compare to non-responder group, the responder group presented significantly larger ΔKtrans(0-3) (0.068 vs -0.078 min-1), ΔKep(0-3) (0.071 vs -0.111 min-1) and Δvp (0.009 vs -0.031) values after NAC (p <0.05). The CR group after CRT exhibited significantly lower Ktrans(Day40-Tx) than residual group (0.264 vs 0.35 min-1, p =0.05) and larger ΔKtrans(0-3) by contrary (0.044 vs -0.069 min-1, p =0.05). For the above parameters, we gained high sensitivity (range from 74.1% to 90%) and moderate to high specificity (range from 50% to 84.3%) to distinguish non-responders from responders, with promising diagnosis efficiency range from 69.3% to 88%.

CONCLUSION

Our study showed that DCE-MRI was feasible to non-invasively monitor therapy response of NPC. Changes of kinetic parameters early after treatment were potential markers for NPC patients who received NAC treatment following by CRT.

CLINICAL RELEVANCE/APPLICATION

Vasculature assessment by DCE-MRI prior and during NAC process is valuable to evaluate tumor response to NAC and CRT in NPC. DCE-MRI might afford supplementary non-invasive prognostic markers for NPC.

Cite This Abstract

Yunbin, C, Zheng, D, Liu, X, Chen, W, Chan, Q, Lin, J, xiao, y, Ren, W, Pan, J, Assessment of Response to Chemoradiotherapy for Nasopharyngeal Carcinoma: Value of Dynamic Contrast-Enhanced MR Imaging at 3 T.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006435.html