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Non-invasive imaging biomarkers of cellular injury and proliferation in nasopharyngeal carcinoma: insights from multiparametric MRI
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Non-invasive imaging biomarkers of cellular injury and proliferation in nasopharyngeal carcinoma: insights from multiparametric MRI
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Journal Article
Non-invasive imaging biomarkers of cellular injury and proliferation in nasopharyngeal carcinoma: insights from multiparametric MRI
2025
Overview
Early identification of therapeutic response and tumor proliferative status is essential in nasopharyngeal carcinoma (NPC). Multiparametric MRI-combining IVIM and DCE-provides quantitative biomarkers reflecting tissue diffusion, perfusion, and vascular permeability. We evaluated whether pre-treatment IVIM- and DCE-derived parameters predict short-term response to induction chemotherapy plus concurrent chemoradiotherapy and whether they correlate with tumor proliferation (Ki-67).
In this prospective study (n = 48; January 2021-January 2023), IVIM parameters (D, D*, f) and DCE parameters (K
, K
, V
, V
) were quantified before treatment. Treatment response at 6 months was classified by RECIST 1.1 as complete response (CR) or non-CR. Ki-67 index was determined by immunohistochemistry (cutoff 50%). Group comparisons used t-tests or Mann-Whitney U tests; logistic regression identified independent predictors; ROC analysis evaluated diagnostic performance; Spearman correlation tested associations with Ki-67.
Pre-treatment D was lower in the CR group (0.82 ± 0.12 vs. 0.92 ± 0.11 ×10
mm
/s;
= 0.007). K
and K
were higher in CR (0.95 ± 0.34 vs. 0.30 ± 0.31 min
,
= 0.014; 0.16 ± 0.09 vs. 0.11 ± 0.06 min
,
= 0.025). D was an independent predictor (
= 0.008). The combined model (D + K
+ K
) yielded AUC = 0.834 (sensitivity 90.0%; specificity 61.4%). Ki-67 correlated negatively with D (r = -0.329,
= 0.022) and positively with V
(r = 0.292,
= 0.044).
Multiparametric MRI can noninvasively predict short-term response and reflect proliferative status in NPC. Integrating IVIM-derived D with DCE-derived K
and K
improves early prediction of treatment efficacy; V
may serve as an imaging surrogate for proliferation.
Publisher
Frontiers Media SA,Frontiers Media S.A
