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Diffusion-weighted imaging of nasopharyngeal carcinoma to predict distant metastases

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Abstract

Our study aimed to identify diffusion-weighted imaging (DWI) parameters obtained from primary nasopharyngeal carcinoma (NPC) at initial presentation, that can predict patients at risk of distant metastases. One hundred and sixty-four patients underwent pretreatment magnetic resonance imaging and DWI. The apparent diffusion coefficient (ADC)mean, ADCskewness, and ADCkurtosis were obtained by histogram analysis. Univariate and multivariate analyses of these ADC parameters together with primary volume (PV), nodal volume (NV), T stage, N stage and presence of locoregional relapse (LRR) were compared between patients with distant metastases (DM+) and patients without distant metastases (DM−) at 5 years using logistic regression. Twenty-eight out of 164 patients (17.1 %) were DM+ (2.5–60 months) and 136/164 patients were DM− (61.2–119.4 months). Compared to DM− patients, the primary tumour of DM+ patients showed significantly lower ADCskewness (ADC values with the greatest frequency were higher) (p = 0.041), and higher PV (p = 0.022), NV (p < 0.01), T stage (p = 0.023), N stage (p < 0.01) and LRR (p < 0.01). On multivariate analysis the ADCskewness was no longer significant (p = 0.120) and only NV and LRR were independent predictors for DM+ (p = 0.023 and 0.021, respectively). DWI showed that compared to DM− patients, DM+ patients had a significantly lower primary tumour ADCskewness, but at initial presentation NV was the only independent predictor of DM.

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong S.A.R, China

    Qi-Yong Ai, Ann D. King, Benjamin King Hong Law, Kunwar S. Bhatia, Anil T. Ahuja & Lok Yiu Sheila Wong

  2. State Key Laboratory in Oncology in South China, Sir Y.K. Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong S.A.R, China

    David Ka-Wai Yeung, Brigette B. Ma, Frankie Kwok Fai Mo & Michael K. M. Kam

  3. Medical Physics and Research Department, Hong Kong Sanatorium and Hospital, Hong Kong S.A.R, China

    Jing Yuan

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  1. Qi-Yong Ai
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  2. Ann D. King
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Correspondence to Ann D. King.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Ai, QY., King, A.D., Law, B.K.H. et al. Diffusion-weighted imaging of nasopharyngeal carcinoma to predict distant metastases. Eur Arch Otorhinolaryngol 274, 1045–1051 (2017). https://doi.org/10.1007/s00405-016-4333-6

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  • DOI: https://doi.org/10.1007/s00405-016-4333-6

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