定量MRI在评估局部晚期鼻咽癌斜坡侵犯中的应用
Quantitative MRI in the assessment of clival invasion in locally advanced nasopharyngeal carcinoma.
文献信息
| PMID | 42723935 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yuqing Lv |
| 作者单位 | Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. |
| 期刊 | Frontiers in oncology |
| SCI 分区 | Q2 |
| IF | 3.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
目的： 本研究评估定量磁共振成像（qMRI）在评估局部晚期鼻咽癌（LA-NPC）斜坡侵犯（CI）及监测治疗反应中的价值。同时探讨CI中qMRI参数变化与鼻咽软组织侵犯消退之间的关系。
方法： 在这项前瞻性研究中，来自单中心的55例伴有CI的LA-NPC患者在基线（t0）、放疗前（t1）、放疗中（t2）和放疗后（t3）接受了qMRI检查。在手动勾画的感兴趣体积中测量T1、T2和T2* mapping。根据RECIST 1.1标准对鼻咽软组织肿瘤消退情况进行评估，将患者分为完全缓解（CR）组和非CR组。以颈椎作为自身对照。
结果： 在基线时，斜坡侵犯的T1、T2和T2* mapping值显著高于正常颈椎（p < 0.001）。治疗期间，CR组（87.3%）表现出T1值显著下降（从基线的841.30 [IQR：521.31] ms降至放疗后的587.61 [IQR：187.54] ms；p<0.001）和T2*值显著下降（从7.27 [IQR：5.28] ms降至4.86 [IQR：3.48] ms；p<0.001），同时T2值显著升高（从89.83 [IQR：18.25] ms升至99.79 [IQR：12.10] ms；p<0.001），而非CR组的T1和T2 mapping值未见显著变化（p > 0.05）。值得注意的是，CR组中t2和t3之间的T1、T2和T2* mapping值无显著差异（p > 0.05）。此外，CR组治疗期间CI与颈椎测量值之间的差异（ΔT1、ΔT2、ΔT2*）减小（p < 0.05）。相反，非CR组的ΔT1 mapping值无显著变化（p = 0.738），但ΔT2和ΔT2* mapping值确实发生了变化（p < 0.001）。
结论： qMRI衍生的T1、T2和T2* mapping在监测LA-NPC的CI反应方面显示出潜在效用，作为一种固有定量工具，值得在更大规模队列中进一步研究。
英文摘要
OBJECTIVE: This study assesses the value of quantitative magnetic resonance imaging (qMRI) in evaluating clival invasion (CI) and monitoring therapeutic response in locally advanced nasopharyngeal carcinoma (LA-NPC). It also investigates the relationship between qMRI parameter changes in CI and regression of nasopharyngeal soft-tissue invasion.
METHODS: In this prospective study, fifty-five LA-NPC patients with CI from a single-center underwent qMRI at baseline (t0), pre-radiotherapy (t1), mid-radiotherapy (t2), and post-radiotherapy (t3). T1, T2, and T2* mappings were measured in manually delineated volumes of interest. Patients were categorized into complete response (CR) and non-CR groups based on nasopharyngeal soft tissue tumor regression per RECIST 1.1. The cervical vertebrae served as self-controls.
RESULTS: At baseline, T1, T2, and T2* mapping values were significantly higher in clival invasion than in normal cervical vertebrae (p < 0.001). During treatment, the CR group (87.3%) exhibited marked decreases in T1 values (from 841.30 [IQR:521.31] ms at baseline to 587.61 [IQR: 187.54] ms at post-RT; p<0.001) and T2* values (from 7.27 [IQR: 5.28] ms to 4.86 [IQR: 3.48] ms; p<0.001), accompanied by a significant increase in T2 values (from 89.83 [IQR: 18.25] ms to 99.79 [IQR: 12.10] ms; p<0.001), whereas the non-CR group showed no significant alterations in T1 and T2 mapping values (p > 0.05). Notably, there were no significant differences in T1, T2, and T2* mapping values between t2 and t3 in the CR group (p > 0.05). Furthermore, differences between CI and cervical vertebrae measurements (ΔT1, ΔT2, ΔT2*) diminished in the CR group during treatment (p < 0.05). Conversely, the non-CR group showed no significant changes in ΔT1 (p = 0.738) mapping values but did exhibit changes in ΔT2 and ΔT2* mapping values (p < 0.001).
CONCLUSIONS: The qMRI-derived T1, T2, and T2* mapping demonstrates potential utility in monitoring CI response in LA-NPC, serving as an inherently quantitative tool that warrants further investigation in larger cohorts.