Diffusion Kurtosis Imaging As An Early Predictor In The Response Of Advanced Nasopharyngeal Carcinoma In One Week

PURPOSE To evaluate the clinical application of Diffusion Kurtosis Imaging(DKI) as a monitor for early predicting concurrent chemo-radiotherapy(CCRT) treatment response in advanced nasopharyngeal carcinoma(NPC) patients.MATERIAL AND METHODS Seventy newly diagnosed advanced NPC patients who received three scheduled MRI scans at baseline(Pre-Tx), after two cycles' neoadjuvant chemotherapy(NAC) and before CCRT(Pre-CCRT), one week after CCRT initiation(CCRT-1w) were enrolled in current study from September 2013 to January 2015. The mathematical change and percentage change of diffusion parameters between CCRT-1w and Pre-CCRT(?1 and ?1%) were calculated, as well as the change between CCRT-1w and Pre-Tx(?2 and ?2%). Patients were divided into responder group(RG) and non-responder group(NRG) after CCRT according to the response evaluation criteria in solid tumors(RECIST). Mann-Whitney U test, Student's t-test, paired c2 test and receiver operating characteristics(ROC) curves analyses were applied in statistical analyzes.RESULTS The ?D1, ?D1%, ?ADC1 and ?ADC1% in RG were significantly larger than those in NRG(P<0.05).The diagnostic accuracy of D correlation parameters was relatively higher than ADC correlation parameters(0.747 vs. 0.693, 0.761 vs. 0.684, respectively). The sensitivity also exhibited a higher value in ?D1, ?D1% and ?D2% of 79.3%, 63.8%, and 74.1% than the parallel ADC values under approximate specificity.CONCLUSION In early predicting tumor response to CCRT in advanced NPC patients, the change of D value and ADC value in one week after CCRT might be an effective marker and DKI may have an advantage over DWI.