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OBJECTIVES: To demonstrate the usefulness of arterial spin labeling (ASL)- tumor blood flow (TBF) and dynamic contrast enhancement (DCE) parameters in predicting the treatment response in patients with nasopharyngeal carcinoma (NPC) after 3-months of radiotherapy.
MATERIALS AND METHODS: Ten NPC patients who underwent magnetic resonance imaging (MRI) examinations with both ASL-TBF and DCE techniques before treatment and at the 3-month follow-up after radiotherapy were divided into complete-response (CR) and partial-response (PR) groups according to the Revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline version 1.1. The ASL-TBF and DCE parameters of the nasopharynx comprised TBF, Ktrans, IAUGC, Kep, and Ve were analyzed and compared between the two groups.
RESULTS: The CR group had a significantly higher pre-treatment Ve ratio (p = 0.038), a higher post-treatment TBF value (p = 0.038), and a higher post-treatment K trans value (p = 0.067) than the PR group.
CONCLUSION: The ASL-TBF and DCE techniques might be useful tools for the prediction of the treatment responses 3-months after radiotherapy in patients with NPC.
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Tangjaturonrasme N, Vatanasapt P, Bychkov A. epidemiology of head and neck cancer in Thailand. Asia Pac
J Clin Oncol 2018;14(1):16-22.
Kanno M, Narita N, Fujimoto Y, et al. Third epidemiological analysis of nasopharyngeal carcinoma in the central region of Japan from 2006 to 2015. Cancers (Basel) 2019;11(8):1180.
King AD, Vlantis AC, Yuen TW, et al. Detection of nasopharyngeal carcinoma by MR imaging: diagnostic accuracy of MRI compared with endoscopy and endoscopic biopsy based on long-term follow-up. AJNR Am J Neuroradiol 2015;36(12):2380-5.
Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual, 8th Edition. New York: Springer; 2017.
Liao XB, Mao YP, Liu LZ, et al. How does magnetic resonance imaging influence staging according to AJCC staging system for nasopharyngeal carcinoma compared with computed tomography? Int J Radiat Oncol Biol Phys 2008;72(5):1368-77.
Fujima N, Yoshida D, Sakashita T, et al. Usefulness of pseudocontinuous arterial spin-labeling for the assessment of patients with head and neck squamous cell carcinoma by measuring tumor blood flow in the pretreatment and early treatment period. AJNR Am J Neuroradiol 2016;37(2):342-8.
Zheng D, Chen Y, Liu X, et al. Early response to chemoradiotherapy for nasopharyngeal carcinoma treatment: Value of dynamic contrast-enhanced 3.0 T MRI. J Magn Reson Imaging 2015;41(6):1528-40.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-47.
Walker-Samuel S, Leach MO, Collins DJ. Evaluation of response to treatment using DCE-MRI: the relationship between initial area under the gadolinium curve (IAUGC) and quantitative pharmacokinetic analysis. Phys Med Biol 2006;51(14):3593-602.
Razek AA, Elsorogy LG, Soliman NY, et al. Dynamic susceptibility contrast perfusion MR imaging in distinguishing malignant from benign head and neck tumors: A pilot study. Eur J Radiol 2011;77:73-9.
Abdel Razek AA, Gaballa G, Ashamalla G, et al. Dynamic susceptibility contrast perfusion-weighted magnetic resonance Imaging and diffusion-weighted magnetic resonance imaging in differentiating recurrent head and neck cancer from post-radiation changes. J Comput Assist Tomogr 2015;39(6):849-54.
Lin M, Yu. X, Luo D, et al. Investigating the correlation of arterial spin labeling and dynamic contrast enhanced perfusion in primary tumor of nasopharyngeal carcinoma. Eur J Radiol 2018;108:222-29.
Liao W, Yang L, Jiang W, et al. Quantitative assessment of vasculature with DCE-MRI in nasopharyngeal carcinomas following radiotherapy and its value for efficacy evaluation. Nan Fang Yi Ke Da Xue Xue Bao 2015;35(7):954-9.
Hou J, Yu X, Hu Y, et al. Value of intravoxel incoherent motion and dynamic contrast-enhanced MRI for predicting the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma. Medicine (Baltimore) 2016;95(35):e4320. doi:10.1097/MD.0000000000004320.
Tuntiyatorn L, Fusuwankaya E, Sawangsilpa T, et al. CT Perfusion in predicting treatment response of nasopharyngeal carcinoma. J Med Assoc Thai 2014;97:333-41.
Songsaeng D, Butnian K, Dankulchai P, et al. Can perfusion computed tomography identify the local recurrence/residual of nasopharyngeal carcinoma. BKK Med J 2019;15(1):19-27.
Lin M, Yu X, Ouyang H, et al. Consistency of T2WI-FS/ASL fusion images in delineating the volume of nasopharyngeal carcinoma. Sci Rep 2015;16(5):1843
Zheng D, Chen Y, Liu X, et al. Dynamic contrast-enhanced MRI of nasopharyngeal carcinoma: A preliminary study of the correlations between quantitative parameters and clinical stage. J Magn Reson Imaging 2014;39(4):940-8.