Value of MRI-DWI and ASL in evaluating the efficacy of chemoradiotherapy for locally advanced nasopharyngeal carcinoma
10.3969/j.issn.1009-0754.2025.10.012
- VernacularTitle:MRI-DWI、ASL联合应用在评估中晚期鼻咽癌同步放化疗效果中的价值
- Author:
Haisheng FU
1
;
Yonggui ZHOU
;
Xuexin WANG
Author Information
1. 810014 青海 西宁,武警青海总队医院
- Keywords:
Magnetic resonance imaging;
Diffusion weighted imaging;
Arterial spin labeling imaging;
Locally advanced stage;
Nasopharyngeal cancer;
Radiochemotherapy
- From:
Journal of Navy Medicine
2025;46(10):1036-1041
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of diffusion-weighted magnetic resonance imaging(MRI-DWI)and arterial spin labeling magnetic resonance imaging(ASL)in evaluating the efficacy of chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma.Methods A total of 103 patients with locally advanced nasopharyngeal carcinoma who received synchronous radiotherapy and chemotherapy in Qinghai Armed Police Corps Hospital from January 2021 to December 2023 were selected as research subjects.The apparent diffusion coefficient(ADC)of the primary tumor,the volume of primary tumor(GTVnx),the volume of the primary tumor+the volume of retropharyngeal lymph nodes(GTVnx+RLN),and the tumor blood flow(TBF)of ASL quantitative perfusion parameters were compared between effective 73 case and ineffective patients(30 case)before and after chemoradiotherapy.The receiver operating characteristics(ROC)curves were used to evaluate the value of ADC,GTVnx,GTVnx+RLN and TBF in predicting the efficacy of chemoradiotherapy in nasopharyngeal carcinoma patients.Univariate method was used to analyze the basic data of patients,and Logistic regression model was used to analyze the related factors of chemoradiotherapy of locally advanced nasopharyngeal carcinoma.Results After concurrent chemoradiotherapy,73 patients were included in the effective group,including 36 patients achieving complete remission(CR)and 37 patients achieving partial remission(PR);30 patients were included in the ineffective group,including 25 patients achieving stable disease(SD)and 5 patients achieving disease progression(PD).Before and after treatment,ADC,GTVnx,GTVnx+RLN in the effective group were significantly lower than those in the ineffective group,and TBF in the effective group was higher than that in the ineffective group(P<0.05).The changes of ADC,GTVnx,GTVnx+RLN,and TBF before and after concurrent chemoradiotherapy in the effective group were significantly higher than those in the ineffective group(P<0.05).The area under the curve(AUC)values of ADC,GTVnx,GTVnx+RLN,and TBF for predicting the efficacy of concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma were 0.727,0.555,0.753,and 0.791,respectively.The results of logistic regression model showed that high levels of ADC,GTVnx and GTVnx+RLN,low level of TBF,TNM stage Ⅳ,and low tumor differentiation before treatment were independent risk factors for poor efficacy of concurrent chemoradiotherapy in nasopharyngeal carcinoma patients(P<0.05).Conclusion Elevated baseline of ADC,GTVnx and GTVnx+RLN and reduced TBF are correlated with poorer outcomes following chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma,serving as potential predictive biomarkers.
