Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China.
Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Eur Radiol. 2023 Dec;33(12):9052-9062. doi: 10.1007/s00330-023-09837-0. Epub 2023 Jul 5.
To evaluate the predictive performance of pretreatment dual-energy CT (DECT) for early response to induction chemotherapy and survival in nasopharyngeal carcinoma (NPC).
In this retrospective study, 56 NPC patients who underwent pretreatment DECT scans with posttreatment follow-up were enrolled. The DECT-derived normalised iodine concentration (nIC), effective atomic number (Zeff), 40-180 keV (20 keV interval), and Mix-0.3 value of the tumour lesions were measured to predict the early response to induction chemotherapy and survival in nasopharyngeal carcinoma. The Mann‒Whitney U test, ROC analysis, Kaplan‒Meier method with log-rank test, and Cox proportional hazards model were performed to evaluate the predictive performance of DECT parameters, respectively.
Among all DECT-derived parameters, ROC analysis showed the predictive performances of nIC and Zeff values for early objective response to induction chemotherapy (AUCs of 0.803 and 0.826), locoregional failure-free survival (AUCs of 0.786 and 0.767), progression-free survival (AUCs of 0.856 and 0.731) and overall survival (AUCs of 0.765 and 0.799) in NPC patients, respectively (all p < 0.05). Moreover, multivariate analysis showed that a high nIC value was an independent predictor of poor survival in NPC. In addition, survival analysis indicated that NPC patients with higher nIC values in primary tumours tend to have lower 5-year locoregional failure-free survival, progression-free survival and overall survival rates than those with lower nIC values.
DECT-derived nIC and Zeff values can predict early response to induction chemotherapy and survival in NPC; in particular, a high nIC value is an independent predictive factor of poor survival in NPC.
Preoperative dual-energy computed tomography may provide predictive value for early response and survival outcomes in patients with nasopharyngeal carcinoma, and facilitate their clinical management.
• Pretreatment dual-energy computed tomography helps to predict early response to therapy and survival in NPC. • NIC and Zeff values derived from dual-energy computed tomography can predict early objective response to induction chemotherapy and survival in NPC. • A high nIC value is an independent predictive factor of poor survival in NPC.
评估预处理双能 CT（DECT）对鼻咽癌（NPC）诱导化疗早期反应和生存的预测性能。
本回顾性研究纳入了 56 例接受预处理 DECT 扫描并进行治疗后随访的 NPC 患者。测量肿瘤病变的 DECT 衍生正常碘浓度（nIC）、有效原子序数（Zeff）、40-180keV（20keV 间隔）和 Mix-0.3 值，以预测诱导化疗早期反应和 NPC 患者的生存情况。采用 Mann-Whitney U 检验、ROC 分析、Kaplan-Meier 对数秩检验和 Cox 比例风险模型分别评估 DECT 参数的预测性能。
在所有 DECT 衍生参数中，ROC 分析显示 nIC 和 Zeff 值对诱导化疗早期客观反应（AUCs 为 0.803 和 0.826）、局部区域无失败生存（AUCs 为 0.786 和 0.767）、无进展生存（AUCs 为 0.856 和 0.731）和总生存（AUCs 为 0.765 和 0.799）具有较好的预测性能（均 p<0.05）。此外，多变量分析显示，高 nIC 值是 NPC 患者生存不良的独立预测因子。此外，生存分析表明，原发肿瘤 nIC 值较高的 NPC 患者 5 年局部区域无失败生存率、无进展生存率和总生存率均低于 nIC 值较低的患者。
DECT 衍生的 nIC 和 Zeff 值可预测 NPC 患者的诱导化疗早期反应和生存情况；特别是，高 nIC 值是 NPC 患者生存不良的独立预测因素。
术前双能 CT 可为鼻咽癌患者的早期治疗反应和生存结果提供预测价值，并有助于其临床管理。
预处理双能 CT 有助于预测 NPC 患者的治疗早期反应和生存。
双能 CT 衍生的 NIC 和 Zeff 值可预测 NPC 患者诱导化疗早期客观反应和生存。
高 nIC 值是 NPC 患者生存不良的独立预测因素。
