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Amide proton transfer MRI detects early changes in nasopharyngeal carcinoma: providing a potential imaging marker for treatment response

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Abstract

Purpose

To determine if treatment of nasopharyngeal carcinoma (NPC) induces early changes in amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI), and to perform a preliminary evaluation of APTw imaging in response assessment.

Methods

Sixteen patients with NPC planned for treatment with radiotherapy and/or chemotherapy underwent APTw imaging of the primary tumour pre-treatment and 2-week intra-treatment. Difference in pre- and intra-treatment APT mean (APTmean) was compared using the Wilcoxon signed rank test. Differences in APTmean and percentage change (%Δ) in APTmean were compared between responders and non-responders based on the outcome at 6 months, using the Mann–Whitney U test.

Results

APTmean decreased in 9/16 (56.3%) and increased in 7/16 (43.7%) with no significant difference between the pre- and intra-treatment APT values for the whole group (p > 0.05). NPC showed response in 11/16 (68.8%) and non-response in 5/11 (31.2%). There were significant differences between the %Δ of responders and non-responders for APTmean (p = 0.01). Responders showed %Δ decrease in APTmean of − 23.12% while non-responders showed a %Δ increase in APTmean of + 102.28%.

Conclusion

APT value changes can be detected in early intra-treatment. Intra-treatment %Δ APTmean shows potential in predicting short-term outcome.

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Acknowledgements

The authors thank Dr Jinyuan Zhou, Department of Radiology, Johns Hopkins University, for providing technical advice on pulse sequencing.

Funding

The work described in this paper was supported by grants from the Research Grants council of the Hong Kong Special Administrative Region, China (Project no. CUHK141070/14 and SEG_CUHK02).

Author information

Authors and Affiliations

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

    Sahrish Qamar, Ann D. King, Qi-Yong Ai, Benjamin King Hong Law, Janet S. M. Chan, Weitian Chen, Anil T. Ahuja & Yi-Xiang Wang

  2. Department of Clinical Oncology, State Key Laboratory Translational Oncology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong S.A.R., China

    Darren M. C. Poon, Macy Tong, Frankie Kwok Fai Mo, Brigette B. Y. Ma & David Ka-Wai Yeung

  3. Imaging Department, St Mary’s Hospital, Imperial College Healthcare, National Health Service Trust, London, UK

    Kunwar S. Bhatia

  4. Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong S.A.R., China

    Jing Yuan

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  1. Sahrish Qamar
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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 standard.

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Informed consent was obtained from all individual participants included in the study.

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Qamar, S., King, A.D., Ai, QY. et al. Amide proton transfer MRI detects early changes in nasopharyngeal carcinoma: providing a potential imaging marker for treatment response. Eur Arch Otorhinolaryngol 276, 505–512 (2019). https://doi.org/10.1007/s00405-018-5231-x

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