Ai Qi Yong H, King Ann D, Tsang Yip Man, Yu Ziqiang, Mao Kaijing, Mo Frankie K F, Wong Lun M, Leung Ho Sang, So Tiffany Y, Hui Edwin P, Ma Brigette B Y, Chen Weitian
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong S.A.R., P.R. China.
Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., P.R. China.
Eur Radiol. 2025 Mar;35(3):1265-1275. doi: 10.1007/s00330-024-10948-5. Epub 2024 Aug 27.
To investigate the potential of T1rho, a new quantitative imaging sequence for cancer, for pre and early intra-treatment prediction of treatment response in nasopharyngeal carcinoma (NPC) and compare the results with those of diffusion-weighted imaging (DWI).
T1rho and DWI imaging of primary NPCs were performed pre- and early intra-treatment in 41 prospectively recruited patients. The mean preT1rho, preADC, intraT1rho, intraADC, and % changes in T1rho (ΔT1rho%) and ADC (ΔADC%) were compared between residual and non-residual groups based on biopsy in all patients after chemoradiotherapy (CRT) with (n = 29) or without (n = 12) induction chemotherapy (IC), and between responders and non-responders to IC in the subgroup who received IC, using Mann-Whitney U-test. A p-value of < 0.05 indicated statistical significance.
Significant early intra-treatment changes in mean T1rho (p = 0.049) and mean ADC (p < 0.01) were detected (using paired t-test), most showing a decrease in T1rho (63.4%) and an increase in ADC (95.1%). Responders to IC (n = 17), compared to non-responders (n = 12), showed higher preT1rho (64.0 ms vs 66.5 ms) and a greater decrease in ΔT1rho% (- 7.5% vs 1.3%) (p < 0.05). The non-residual group after CRT (n = 35), compared to the residual group (n = 6), showed higher intraADC (0.96 vs 1.09 × 10 mm/s) and greater increase in ΔADC% (11.7% vs 27.0%) (p = 0.02).
Early intra-treatment changes are detectable on T1rho and show potential to predict tumour shrinkage after IC. T1rho may be complementary to DWI, which, unlike T1rho, did not predict response to IC but did predict non-residual disease after CRT.
T1rho has the potential to complement DWI in the prediction of treatment response. Unlike DWI, it predicted shrinkage of the primary NPC after IC but not residual disease after CRT.
Changes in T1rho were detected early during cancer treatment for NPC. Pre-treatment and early intra-treatment change in T1rho predicted response to IC, but not residual disease after CRT. T1rho can be used to complement DWI with DWI predicting residual disease after CRT.
研究一种用于癌症的新型定量成像序列T1rho在鼻咽癌（NPC）治疗前及治疗早期预测治疗反应的潜力，并将结果与扩散加权成像（DWI）的结果进行比较。
对41例前瞻性招募的患者在治疗前及治疗早期进行原发性NPC的T1rho和DWI成像。在所有接受放化疗（CRT）（n = 29）或未接受诱导化疗（IC）（n = 12）的患者中，基于活检比较残余组和非残余组之间的平均治疗前T1rho、治疗前表观扩散系数（ADC）、治疗中T1rho、治疗中ADC以及T1rho（ΔT1rho%）和ADC（ΔADC%）的变化百分比，在接受IC的亚组中比较IC反应者和非反应者之间的上述指标，采用Mann-Whitney U检验。p值<0.05表示具有统计学意义。
检测到治疗中早期平均T1rho（p = 0.049）和平均ADC（p < 0.01）有显著变化（采用配对t检验），大多数显示T1rho降低（63.4%）和ADC升高（95.1%）。与非反应者（n = 12）相比，IC反应者（n = 17）显示出更高的治疗前T1rho（64.0 ms对66.5 ms）和更大的ΔT1rho%降低（-7.5%对1.3%）（p < 0.05）。CRT后非残余组（n = 35）与残余组（n = 6）相比，显示出更高的治疗中ADC（0.96对1.09×10⁻³ mm²/s）和更大的ΔADC%升高（11.7%对27.0%）（p = 0.02）。
T1rho可检测到治疗中早期变化，并显示出预测IC后肿瘤缩小的潜力。T1rho可能是DWI的补充，与T1rho不同，DWI不能预测IC反应，但能预测CRT后的无残留疾病。
T1rho在预测治疗反应方面有潜力补充DWI。与DWI不同，它可预测IC后原发性NPC的缩小，但不能预测CRT后的残留疾病。
在NPC癌症治疗早期检测到T1rho的变化。治疗前和治疗中早期T1rho变化可预测IC反应，但不能预测CRT后的残留疾病。T1rho可用于补充DWI，而DWI可预测CRT后的残留疾病。
