Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model-Free Dynamic Contrast-Enhanced Magnetic Resonance Imaging

作者：Guo, Baoliang; Ouyang, Fusheng; Ouyang, Lizhu; Huang, Xiyi; Guo, Tiandi; Lin, Shaojia; Liu, Ziwei; Zhang, Rong; Yang, Shao-min; Chen, Haixiong; Hu, Qiu-gen^*

来源：Journal of Magnetic Resonance Imaging, 2021, 54(1): 91-100.

DOI：10.1002/jmri.27537

• hypopharyngeal carcinoma
• intra&#8208
• voxel incoherent motion
• dynamic contrast&#8208
• enhanced MR imaging
• induction chemotherapy
• treatment response

Background Multiparametric intravoxel incoherent motion (IVIM) provides diffusion and perfusion information for the treatment prediction of cancer. However, the superiority of IVIM over dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in locally advanced hypopharyngeal carcinoma (LAHC) remains unclear. @@@ Purpose To compare the diagnostic performance of IVIM and model-free DCE in assessing induction chemotherapy (IC) response in patients with LAHC. @@@ Study Type Prospective. @@@ Population Forty-two patients with LAHC. @@@ Field Strength/Sequence 3.0 T MRI, including IVIM (12 b values, 0-800 seconds/mm(2)) with a single-shot echo planar imaging sequence and DCE-MRI with a volumetric interpolated breath-hold examination sequence. IVIM MRI is a commercially available sequence and software for calculation and analysis from vendor. @@@ Assessment The IVIM-derived parameters (diffusion coefficient [D], pseudodiffusion coefficient [D*], and perfusion fraction [f]) and DCE-derived model-free parameters (Wash-in, time to maximum enhancement [Tmax], maximum enhancement [Emax], area under enhancement curve [AUC] over 60 seconds [AUC(60)], and whole area under enhancement curve [AUC(w)]) were measured. At the end of IC, patients with complete or partial response were classified as responders according to the Response Evaluation Criteria in Solid Tumors. @@@ Statistical Tests The differences of parameters between responders and nonresponders were assessed using Mann-Whitney U tests. The performance of parameters for predicting IC response was evaluated by the receiver operating characteristic curves. @@@ Results Twenty-three (54.8%) patients were classified as responders. Compared with nonresponders, the perfusion parameters D*, f, f x D*, and AUC(w) were significantly higher whereas Wash-in was lower in responders (all P-values <0.05). The f x D* outperformed other parameters, with an AUC of 0.84 (95% confidence interval [CI]: 0.69-0.93), sensitivity of 79.0% (95% CI: 54.4-93.9), and specificity of 82.6% (95% CI: 61.2-95.0). @@@ Data Conclusion The IVIM MRI technique may noninvasively help predict the IC response before treatment in patients with LAHC. @@@ Level of Evidence 2 @@@ Technical Efficacy Stage 2

• 单位
  1; 南方医科大学