Diffusion Kurtosis Imaging Monitor The Early Neoadjuvant Chemotherapy Response Of Metastatic Lymph Nodes From Advanced Nasopharyngeal Carcinoma

Objectives:To apply Diffusion Kurtosis Imaging(DKI)and diffusion-weighted imaging(DWI)in metastatic lymph nodes of nasopharyngeal carcinoma,by mo nitoring MD value ?MK value and the apparent diffusion coefficient(ADC)t o assess early treatment response after neoadjuvant chemotherapy(NAC).Materials and Methods:Prospectively select 29 patiences were confirmed path ologyly with nasopharyngeal carcinom.The patiences underwent four DKI and DWI scans:before and on 4th and 21 th as well as 42 th day after NAC initiati on.Select each group largest metastatic lymph nodes with axial short-axis ?15mm of retropharynx and neck.For each point in time,the quantitative parame ters MD,MK,ADC and axial short-axis of metastatic lymph nodes were measur ed.Then we calculated the changes of each parameters before and after treat ment and calculated metastatic lymph nodes shrinking ratio at the end of the second cycle.Patients were divided into responder group(RG)and non-respon der group(NRG)after according to the RECIST1.1 responsevaluation criteria.Mann-Whitney U test,Student's t-test,paired?2 and receiver operating characte ristics curves(ROC)analyses were applied in statistical analyzes.RESULTS:The MD4,?MD4,ADC4 in RG were significantly larger than those in NRG.No significant difference were found between the two groups in MK.For evaluating treatment response to NAC,MD4 in AUCs(Area Under Curve)of 0.748,ADC4 in AUCs of 0.725.MD4 was more sensitive than ADC4 to predict treatment response to NAC.Conclusion: 44,4in patients with nasopharyngeal carcinoma after NAC.DKI may have an advantage over DWI for predicting early response to NAC.