[Value of readout-segmented echo-planar diffusion imaging on 3.0 T MRI for predicting the early efficacy of concurrent radiochemotherapy of advanced stage nasopharyngeal carcinoma patients].

• DOI: 10.3760/cma.j.issn.0376-2491.2017.07.005
• Publication Date: 2017-02-21
• Authors: Congcong Xu; Jun Yuan; X J Chen; Jinrong Qu; L.F. Wang; Yupei Zhao; H K Zhang; Huiyu Ge; Xuejian Sun; X X Zhang; H L Li
• Keywords: Youden's J statistic; Cut-off

Objective: To discuss the value of RESOLVE for predicting early therapeutic effect concourrent radiochemotherapy in advanced stage nasopharngeal carcinoma patients. Methods: Sixty-eight patients with nasopharyngeal were confirmed by pathology Henan Cancer Hospital from June 2014 to January 2016.All underwent RESLOVE(b value=800 s/mm(2)) a 3.0 T MRI scanner.The ADC and area tumor was measured before treatment 2 weeks after independently performed two radiologists 5 years experiences agreement evaluation using ANOVA analysis.The correlation among pretreatment value, type, gender, regression rate analyzed Spearman rank test.The difference between compared CR group non-CR independent sample t test.ROC curve drawn maximum Youden index cutoff calculating sensitivity, specificity under curve. Results: (1)The radiologist excellent. The ICC values 0.89, 0.92 0.95, respectively. (2)The (0.877±0.103)×10(-3) mm(2)/s (0.779±0.078)×10(-3) mm(2)/s, There statistical value=2.874, P value=0.005.(3)ROC showed that sensitivity 85.2% 71.0%, cut-off 0.792×10(-3) 0.778.(4)There apparently beween rate(r=0.333, P=0.006). no gender (P>0.05). Conclusion: is important concurrent patients.目的：探讨3.0 T磁共振成像(MRI)读出方向上的分段扩散成像技术(RESOLVE)在预测局部晚期鼻咽癌同步放化疗早期疗效中的价值。 方法：分析2014年6月至2016年1月河南省肿瘤医院经病理证实的68例局部晚期鼻咽癌患者，利用3.0 MRI扫描仪进行RESOLVE扫描(b值＝800 s/mm(2))，由2名5年以上工作经验的放射科诊断医师采用双盲法分别测量治疗前及同步放化疗2周后病灶区的表观扩散系数(ADC)值及感兴趣区(ROI)面积，并采用ANOVA分析对2名医师的测量结果行一致性评价。以Spearman等级相关分析评价肿瘤治疗前的ADC值与病理组织学类型、患者临床特点、ROI面积、肿瘤消退率的相关性分析；采用独立样本t检验比较完全缓解(CR)组与非CR组治疗前ADC值的差异；绘制ROC曲线，以约登(youden)指数最大时ADC值为界值，计算ADC值，预测CR的敏感度、特异度及曲线下面积(AUC)。 结果： (1)2名医师所测结果一致性极好，治疗前肿瘤的ADC值和ROI面积以及治疗后非CR组ROI面积的ICC值分别为0.89、0.92及0.95。(2)CR组与非CR组患者治疗前肿瘤的ADC值分别为[(0.877±0.103)×10(-3) mm(2)/s]和[(0.779±0.078)×10(-3) mm(2)/s]，二者差异有统计学意义(t＝2.874, P＝0.005) 。(3)治疗前ADC值预测CR的曲线下面积(AUC)为0.778，以治疗前ADC值0.792×10(-3) mm(2)/s作为预测CR的界值，敏感度及特异度分别为85.2%和71.0%。(4)治疗前肿瘤的ADC值与同步放化疗2周后肿瘤的消退率具有明显相关性(r＝0.333，P＝0.006)，但与患者的病理组织学类型、性别、年龄及肿瘤面积均无相关性(均P>0.05)。 结论：采用RESOLVE技术所测肿瘤的ADC值对预测局部晚期鼻咽癌同步放化疗早期疗效具有重要价值。.