酰胺质子转移成像技术在鼻咽癌放化疗后疗效预测的 价值

The value of amide proton transfer imaging in predicting the effect of nasopharyngeal carcinoma after chemoradiotherapy

目的探讨酰胺质子转移(amide proton transfer,APT)成像在中短期随访中对鼻咽癌放化疗疗效预测的价值。材料与方法回顾性分析40例鼻咽癌放化疗的临床和影像资料,其中复发组14例,非复发组26例,并对这两组病例的癌灶进行APT值测量。运用秩和检验比较治疗中和治疗前复发组与非复发组的APT水平差异,并绘制ROC曲线计算其诊断效能。结果治疗前本研究的复发组和非复发组APT值的均数、中位数、第90%位数差异没有统计学意义(P>0.05)。经2程化疗和5次放疗后,复发组和非复发组两者均数之间的差异无统计学意义(P>0.05);中位数、第90%位数在复发组和非复发组分别为(2.08±0.26)%、(1.86±0.35)%,(4.45±0.86)%、(3.64±0.70)%,它们两两之间差异有统计学意义(P<0.05)。另外,中位数和第90%位数的最佳阈值、敏感度、特异度、曲线下面积、95%置信区间分别为1.80%、85.7%、65.4%、0.753、0.605~0.901和3.92%、85.7%、69.2%、0.786、0.627~0.945。结论APT的中位数结合第90%位数,可以较好地预测鼻咽癌放化疗的疗效。

Objective:To investigate the value of amide proton transfer(APT)imaging in predicting the efficacy of radiochemotherapy in nasopharyngeal carcinoma(NPC)during short and medium follow-up.Materials and Methods:The clinical information and MRI data of 40 NPC patients with radiochemotherapy were analyzed retrospectively.The patients were divided into two groups of recurrent group(n=14)and non-recurrence group(n=26).APT values were measured for each group.The rank sum test was used to compare the APT difference between the two groups before and during treatment.Receiver operator characteristic curve(ROC)was plotted to assess the diagnostic efficacy.Results:There was no significant difference in the mean,median and 90th percentile of APT between the recurrent and non-recurring groups before treatment.After 2 courses of chemotherapy and 5 courses of radiotherapy,although there was no significant difference of mean APT values between the two groups,the median and 90th percentile APT values were significantly different between the recurrent[(2.08±0.26)% and(4.45±0.86)% for median and 90th percentile values,respectively]and non-recurrence[(1.86±0.35)% and(3.64±0.70)% for median and 90th percentile values,respectively]groups(P<0.05).In addition,the optimum threshold,sensitivity,specificity,the area under the ROC curve(AUC),and 95% confidence interval of median and 90% digits are 1.80%,85.7%,65.4%,0.753,0.605-0.901 and 3.92%,85.7%,69.2%,0.786,0.627—0.945,respectively.Conclusions:The median of APT combined with 90th percentile can better predict the efficacy of radiochemotherapy for NPC.