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Early Assessment of Induction Chemotherapy Response of Nasopharyngeal Carcinoma by Pretreatment Diffusion-Weighted Magnetic Resonance Imaging

Zheng, Dechun MS*; Chen, Yunbin MD*; Chen, Ying BS*; Xu, Luying BS; Lin, Fengjie BS; Lin, Jin BS; Huang, Chaobin BS; Pan, Jianji MD

Journal of Computer Assisted Tomography: September/October 2013 - Volume 37 - Issue 5 - p 673–680
doi: 10.1097/RCT.0b013e31829a2599

Objectives: This study aimed to evaluate the feasibility of pretreatment diffusion-weighted imaging in predicting response after induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC).

Methods: Fifty-four patients with stage III and IV NPC underwent MRI examination at baseline, after 2 cycles of chemotherapy, and at the end of chemoradiotherapy. Apparent diffusion coefficient (ADC) values were compared between effective and ineffective subjects after IC.

Results: Mean ADC in effective groups was significantly (P < 0.05) higher than that in the ineffective group. Average and minimum ADCs demonstrated higher sensitivity than maximum ADC for predicting IC response, with 68.4%, 71.1%, and 50.0%, respectively, at an equivalent 68.7% specificity. We observed negative correlations between pretreatment ADC and tumor regression after chemotherapy (γ = − 0.425, P = 0.001) and after chemoradiotherapy (γ = − 0.418, P = 0.003).

Conclusions: Pretreatment ADC was a valuable biomarker for predicting IC response of NPC. Noninvasive diffusion-weighted imaging provides additional indicator in guiding optical therapeutic options for patients with NPC.

From the Departments of *Radiology, and †Radiation Oncology, Fujian Provincial Cancer Hospital and Institute, Fuzhou, Fujian, People’s Republic of China.

Received for publication April 24, 2013; accepted May 2, 2013.

Reprints: Yunbin Chen, MD, Department of Radiology, Fujian Provincial Cancer Hospital and Institute, No. 420, Fuma road, Jin’an District, Fuzhou, Fujian, People’s Republic of China 350014 (e-mail:

This work was supported by the Natural Science Foundation of Fujian Province (2012J01330).

The authors have no conflict of interest to declare.

© 2013 by Lippincott Williams & Wilkins