title: Early response to chemoradiotherapy for nasopharyngeal carcinoma treatment: Value of dynamic contrast-enhanced 3.0 T MRI.
abstract: OBJECTIVE
  To prospectively evaluate the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) value for predicting early nasopharyngeal carcinoma (NPC) chemoradiotherapy (CRT) response.
  
  
  METHODS
  Forty-two patients with advanced NPC were recruited and received three DCE-MRI exams before treatment (Pre-Tx), as well as 3 days (Day 3-Tx) and 40 days (Day 40-Tx) after chemotherapy initiation (two neoadjuvant chemotherapy cycles, NAC). We used DCE-Tool to measure primary tumor kinetic parameters (K(trans) , Kep , ve , and vp ) using the extended Tofts model. Kinetic parameters and corresponding changes were compared between responders and nonresponders after NAC or CRT treatment using Student's t or Mann-Whitney U tests.
  
  
  RESULTS
  Response to two NAC cycles correlated with short-term local control (P = 0.01). Compared to the nonresponder group, the responder group presented with significantly larger ΔK(trans) (0-3) , ΔKep(0-3) , and Δvp(0-3) values after NAC (P < 0.05). The complete response group after CRT exhibited significantly lower K(trans) (Day 40-Tx) and larger ΔK(trans) (0-3) values than the residual group (P = 0.05). High sensitivity (range: 74.1%-90%) and moderate-to-high specificity (range: 50%-84.3%) distinguished nonresponders from responders grouping after NAC or CRT, with diagnostic efficiency ranging from 69.3%-88%.
  
  
  CONCLUSIONS
  Our study showed kinetic parameter changes earlier after chemotherapy were potential markers for NPC patients receiving CRT therapy following NAC.
authors.affiliation: Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Dechun
authors.initials: D
authors.lastname: Zheng
authors.affiliation: Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Yunbin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Luying
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital & Institute, Fuzhou, Fujian, People's Republic of China.
authors.forename: Wang
authors.initials: W
authors.lastname: Ren
authors.affiliation: Philips Healthcare, Shanghai, People's Republic of China.
authors.forename: Weibo
authors.initials: W
authors.lastname: Chen
authors.affiliation: Philips Healthcare, Hong Kong.
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
mesh_terms: D002277:Carcinoma; D059248:Chemoradiotherapy; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: DCE-MRI; nasopharyngeal carcinoma; neoadjuvant chemotherapy; radiation therapy; therapy response