AUTHOR=Qin Yuhui , Chen Chen , Chen Haotian , Gao Fabao 

TITLE=The value of intravoxel incoherent motion model-based diffusion-weighted imaging for predicting long-term outcomes in nasopharyngeal carcinoma

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.902819

DOI=10.3389/fonc.2022.902819

ISSN=2234-943X

ABSTRACT=<sec><title>Objective</title><p>The aim of this study was to evaluate the prognostic value for survival of parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in patients with nasopharyngeal carcinoma (NPC).</p></sec><sec><title>Materials</title><p>Baseline IVIM-DWI was performed on 97 newly diagnosed NPC patients in this prospective study. The relationships between the pretreatment IVIM-DWI parametric values (apparent diffusion coefficient (ADC), D, D*, and f) of the primary tumors and the patients’ 3-year survival were analyzed in 97 NPC patients who received chemoradiotherapy. The cutoff values of IVIM parameters for local relapse-free survival (LRFS) were identified by a non-parametric log-rank test. The local-regional relapse-free survival (LRRFS), LRFS, regional relapse-free survival (RRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were calculated by using the Kaplan–Meier method. A Cox proportional hazards model was used to explore the independent predictors for prognosis.</p></sec><sec><title>Results</title><p>There were 97 participants (mean age, 48.4 ± 10.5 years; 65 men) analyzed. Non-parametric log-rank test results showed that the optimal cutoff values of ADC, D, D*, and f were 0.897 × 10<sup>−3</sup> mm<sup>2</sup>/s, 0.699 × 10<sup>−3</sup> mm<sup>2</sup>/s, 8.71 × 10<sup>−3</sup> mm<sup>2</sup>/s, and 0.198%, respectively. According to the univariable analysis, the higher ADC group demonstrated significantly higher OS rates than the low ADC group (<italic>p</italic> = 0.036), the higher D group showed significantly higher LRFS and OS rates than the low D group (<italic>p</italic> = 0.028 and <italic>p</italic> = 0.017, respectively), and the higher D* group exhibited significantly higher LRFS and OS rates than the lower D* group (<italic>p</italic> = 0.001 and <italic>p</italic> = 0.002, respectively). Multivariable analyses indicated that ADC and D were the independent prognostic factors for LRFS (<italic>p</italic> = 0.041 and <italic>p</italic> = 0.037, respectively), D was an independent prognostic factor for LRRFS (<italic>p</italic> = 0.045), D* and f were the independent prognostic factors for OS (<italic>p</italic> = 0.019 and 0.029, respectively), and f acted was an independent prognostic factor for DMFS (<italic>p</italic> = 0.020).</p></sec><sec><title>Conclusions</title><p>Baseline IVIM-DWI perfusion parameters ADC and D, together with diffusion parameter D*, could act as useful factors for predicting long-term outcomes and selecting high-risk patients with NPC.</p></sec>