Prognostic utility of 18 F-FDG PET/MRI with intravoxel incoherent motion imaging in nasopharyngeal carcinoma.
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| Titel: | Prognostic utility of 18 F-FDG PET/MRI with intravoxel incoherent motion imaging in nasopharyngeal carcinoma. |
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| Autoren: | Chan SC; Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.; School of Medicine, Tzu Chi University, Hualien, Taiwan., Ng SH; Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, 333423, Taoyuan, Taiwan. shuhangng@gmail.com., Yeh CH; Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, 333423, Taoyuan, Taiwan., Lin YC; Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, 333423, Taoyuan, Taiwan., Lin CY; Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, 333423, Taiwan., Wang JH; Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan., Cheng NM; Department of Nuclear Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan., Chen SH; Department of Nuclear Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan., Chang KP; Department of Otorhinolaryngology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan., Hsieh JC; Division of Hematology/Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. |
| Quelle: | European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2025 Dec; Vol. 53 (1), pp. 338-349. Date of Electronic Publication: 2025 Jul 02. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Springer-Verlag Berlin Country of Publication: Germany NLM ID: 101140988 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1619-7089 (Electronic) Linking ISSN: 16197070 NLM ISO Abbreviation: Eur J Nucl Med Mol Imaging Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin : Springer-Verlag Berlin, 2002- |
| MeSH-Schlagworte: | Fluorodeoxyglucose F18* , Nasopharyngeal Carcinoma*/diagnostic imaging , Nasopharyngeal Neoplasms*/diagnostic imaging , Nasopharyngeal Neoplasms*/pathology , Positron-Emission Tomography* , Motion* , Magnetic Resonance Imaging*, Humans ; Male ; Female ; Middle Aged ; Prognosis ; Adult ; Aged ; Carcinoma/diagnostic imaging ; Diffusion Magnetic Resonance Imaging ; Multimodal Imaging ; Prospective Studies ; Young Adult |
| Abstract: | Competing Interests: Declarations. Ethics approval: This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB no. 103-7498A3), registered at CinicalTrial.gov (NCT03429868), and conducted in accordance with the 1964 Declaration of Helsinki and all subsequent revisions. Consent to participate: Informed written consent was obtained from all individual participants included in the study. Competing interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Purpose: Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) enhances tissue diffusion assessment by differentiating true molecular diffusion from microvascular perfusion, surpassing conventional DWI. This prospective study assessed the prognostic utility of 18 F-FDG PET/MRI with IVIM imaging in patients with primary nasopharyngeal carcinoma (NPC). Methods: We prospectively enrolled 148 patients with primary NPC who underwent pretreatment PET/MRI. Quantitative parameters derived from IVIM-DWI, dynamic contrast-enhanced MRI (DCE-MRI), and 18 F-FDG PET were analyzed for their associations with overall survival (OS) and recurrence-free survival (RFS). Results: IVIM-derived minimal true diffusion coefficient (D Conclusion: Integrated PET/MRI with IVIM imaging enables simultaneous quantification of water molecule diffusion, tumor microvascular perfusion, and glucose metabolism in NPC, yielding complementary imaging biomarkers that demonstrate superior prognostic value compared to conventional TNM staging. Trial Registration: ClinicalTrials.gov (NCT03429868), retrospectively registered on February 6, 2018. (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| Grant Information: | NSC 104-2314-B-182A-084-MY3, 109-2314-B-303-015, 110-2314- B-303-014, and 111-2314-B-303-006 Ministry of Science and Technology; TCRD113-035 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; TCMF-A 110- 03[114] and TCMF-A 110- 03[115] Buddhist Tzu Chi Medical Foundation |
| Contributed Indexing: | Keywords: Intravoxel incoherent motion diffusion; Nasopharyngeal carcinoma; Overall survival; Positron emission tomography/Magnetic resonance imaging; Prognosis; Recurrence-free survival |
| Molecular Sequence: | ClinicalTrials.gov NCT03429868 |
| Substance Nomenclature: | 0Z5B2CJX4D (Fluorodeoxyglucose F18) |
| Entry Date(s): | Date Created: 20250702 Date Completed: 20251127 Latest Revision: 20251127 |
| Update Code: | 20251127 |
| DOI: | 10.1007/s00259-025-07425-6 |
| PMID: | 40601020 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declarations. Ethics approval: This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB no. 103-7498A3), registered at CinicalTrial.gov (NCT03429868), and conducted in accordance with the 1964 Declaration of Helsinki and all subsequent revisions. Consent to participate: Informed written consent was obtained from all individual participants included in the study. Competing interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.<br />Purpose: Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) enhances tissue diffusion assessment by differentiating true molecular diffusion from microvascular perfusion, surpassing conventional DWI. This prospective study assessed the prognostic utility of <sup>18</sup> F-FDG PET/MRI with IVIM imaging in patients with primary nasopharyngeal carcinoma (NPC).<br />Methods: We prospectively enrolled 148 patients with primary NPC who underwent pretreatment PET/MRI. Quantitative parameters derived from IVIM-DWI, dynamic contrast-enhanced MRI (DCE-MRI), and <sup>18</sup> F-FDG PET were analyzed for their associations with overall survival (OS) and recurrence-free survival (RFS).<br />Results: IVIM-derived minimal true diffusion coefficient (D <subscript>min</subscript> ) and perfusion-related diffusion coefficient (D*) were correlated with RFS (p = 0.018 and 0.043, respectively), outperforming the apparent diffusion coefficient (ADC; p = 0.946). Univariate analysis identified age, tumour stage, T classification, primary tumour standardized uptake value (SUVt), nodal SUV (SUVn), and total lesion glycolysis (TLG) as significant OS predictors. Significant predictors of RFS included Epstein-Barr virus DNA titer, SUVn, DCE-MRI parameters (K <subscript>ep</subscript> and V <subscript>e</subscript> ), and IVIM parameters (D* and D <subscript>min</subscript> ). In multivariate analysis, age, SUVt, and TLG were independent OS prognostic factors, whereas SUVn, K <subscript>ep</subscript> , D <subscript>min</subscript> (p = 0.009), and V <subscript>e</subscript> (p = 0.012) independently predicted RFS. Prognostic models incorporating the PET/MRI imaging biomarkers showed a significantly higher integrated AUC and Harrell's C-index than the TNM staging system alone.<br />Conclusion: Integrated PET/MRI with IVIM imaging enables simultaneous quantification of water molecule diffusion, tumor microvascular perfusion, and glucose metabolism in NPC, yielding complementary imaging biomarkers that demonstrate superior prognostic value compared to conventional TNM staging.<br />Trial Registration: ClinicalTrials.gov (NCT03429868), retrospectively registered on February 6, 2018.<br /> (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| ISSN: | 1619-7089 |
| DOI: | 10.1007/s00259-025-07425-6 |