title: Diffusion kurtosis imaging predicts neoadjuvant chemotherapy responses within 4 days in advanced nasopharyngeal carcinoma patients.
abstract: OBJECTIVE
  To explore the clinical value of diffusion kurtosis imaging (DKI) and monoexponential diffusion-weighted imaging (DWI) for predicting early response to neoadjuvant chemotherapy (NAC) in patients with nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Fifty-nine patients with stage III-IVb NPC underwent four 3.0T MR scans: prior to, and on the 4th, 21st, 42nd days after NAC initiation. The parameters of DKI (corrected diffusion coefficient, D; excess diffusion kurtosis coefficient, K) and monoexponential DWI (apparent diffusion coefficient, ADC) were obtained at the first three scans. Statistical methods included Student's t-test or Mann-Whitney U-test, receiver operating characteristic (ROC) curve analyses and paired X(2) test.
  
  
  RESULTS
  D(pre) in responders group (RG) was significantly lower than nonresponders group (NRG) (1.029 ± 0.033 vs. 1.184 ± 0.055, ×10(-3) mm(2) /s, P = 0.020). ADC(day4) and ΔD(day4) were the most useful parameters of the two diffusional models to distinguish RG from NRG, respectively (area under the curve, 0.761 vs. 0.895). ΔD(day4) was more sensitive than ADC(day4) to predict treatment response to NAC (P = 0.006).
  
  
  CONCLUSIONS
  Both DKI and monoexponential DWI showed potential to predict treatment response to NAC prior to morphological change. DKI may be superior to monoexponential DWI for predicting early response to NAC in patients with locally advanced NPC.
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.|Department of Radiology, First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
authors: Yunbin
authors: Y
authors: Chen
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
authors: Wang
authors: W
authors: Ren
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.|Department of Radiology, First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
authors: Dechun
authors: http://orcid.org/0000-0001-8768-1627
authors: D
authors: Zheng
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
authors: Jing
authors: J
authors: Zhong
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
authors: Xiangyi
authors: X
authors: Liu
authors: Department of Radiology, First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
authors: Qiuyuan
authors: Q
authors: Yue
authors: Department of Radiology, First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
authors: Meng
authors: M
authors: Liu
authors: Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
authors: Youping
authors: Y
authors: Xiao
authors: Philips Healthcare, Shanghai, People's Republic of China.
authors: Weibo
authors: W
authors: Chen
authors: Philips Healthcare, Hong Kong, People's Republic of China.
authors: Queenie
authors: Q
authors: Chan
authors: Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
authors: Jianji
authors: J
authors: Pan
mesh_terms: D000328:Adult; D002277:Carcinoma; D017024:Chemotherapy, Adjuvant; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D009305:Nasopharynx / Q000473:pathology; D020360:Neoadjuvant Therapy; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome
keywords: diffusion kurtosis imaging; diffusion-weighted MRI; nasopharyngeal carcinoma; neoadjuvant chemotherapy; treatment monitoring