Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Clin Imaging. 2021 Apr;72:1-7. doi: 10.1016/j.clinimag.2020.10.047. Epub 2020 Nov 4.
To determine the associations between dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters and plasma Epstein-Barr virus (EBV) DNA status and nasopharyngeal carcinoma (NPC) stages.
We prospectively studied the DCE-MRI results of 47 patients with newly diagnosed NPC and their pre-treatment plasma EBV DNA levels. We recruited all patients who had undergone MRI (1.5 T) simulation at the radiation therapy department of our institute between January 2018-2019. Regions of interest were drawn at primary tumors, and DCE-MRI parameters, including mean values of Ktrans, Kep, Ve, and Vp, were recorded. Spearman's rank correlation was used to identify significant associations between the DCE-MRI parameters and the plasma EBV DNA level and NPC stages. Mann-Whitney U tests and unpaired t-test were performed to compare the DCE-MRI parameters among different groups and to identify optimal cut-off values using receiver operating characteristic curves.
We found that the DCE-MRI parameters correlated with the plasma EBV DNA levels and NPC stages. Positive plasma EBV DNA was correlated with lower Kep (optimal cut-off value, 2.1 min; area under the curve [AUC], 0.714) and higher Ve (optimal cut-off value, 0.675; AUC, 0.706). Ve higher than 0.765 (AUC, 0.678) was correlated with plasma EBV DNA (≥2300 copies mL). Higher Ktrans (cut-off value, 1.495 min) was correlated with high-T stage (AUC, 0.767) and high-stage group (AUC, 0.711).
The DCE-MRI parameters are correlated with the plasma EBV DNA status and NPC stages. Therefore, DCE-MRI findings may be used as imaging biomarkers for patients with NPC.
探讨动态对比增强磁共振成像（DCE-MRI）参数与血浆 Epstein-Barr 病毒（EBV）DNA 状态及鼻咽癌（NPC）分期的相关性。
前瞻性研究了 47 例初诊 NPC 患者的 DCE-MRI 结果及其治疗前血浆 EBV DNA 水平。我们招募了所有于 2018 年 1 月至 2019 年期间在我院放射治疗科行 MRI（1.5T）模拟的患者。在原发肿瘤部位勾画感兴趣区，记录 DCE-MRI 参数，包括平均 Ktrans、Kep、Ve 和 Vp 值。采用 Spearman 秩相关分析确定 DCE-MRI 参数与血浆 EBV DNA 水平及 NPC 分期之间的相关性。采用 Mann-Whitney U 检验和独立样本 t 检验比较不同组别间的 DCE-MRI 参数，采用受试者工作特征曲线（ROC 曲线）确定最佳截断值。
我们发现 DCE-MRI 参数与血浆 EBV DNA 水平及 NPC 分期相关。阳性血浆 EBV DNA 与较低的 Kep（最佳截断值为 2.1min，曲线下面积 [AUC]为 0.714）和较高的 Ve（最佳截断值为 0.675，AUC 为 0.706）相关。Ve 高于 0.765（AUC 为 0.678）与血浆 EBV DNA（≥2300 拷贝/ml）相关。较高的 Ktrans（截断值为 1.495min）与高 T 分期（AUC 为 0.767）和高分期组（AUC 为 0.711）相关。
DCE-MRI 参数与血浆 EBV DNA 状态和 NPC 分期相关。因此，DCE-MRI 结果可作为 NPC 患者的影像学生物标志物。
