体素内不相干运动和动态对比增强MRI在预测鼻咽癌放疗疗效的研究进展

Research progress of intravoxel incoherent motion and dynamic contrast-enhanced MRI in radiotherapy response prediction of nasopharyngeal carcinoma

放射治疗是鼻咽癌(nasopharyngeal carcinoma,NPC)主要且有效的治疗方法,治疗前对肿瘤进行可靠的疗效预测能够优化NPC患者的治疗方案,提高患者生存周期。体素内不相干运动(intravoxel incoherent motion,IVIM)和动态对比增强MRI(dynamic contrast-enhanced MRI,DCE-MRI)可提供多种量化指标,定量描述水分子扩散和组织微循环灌注的信息,微观地反映病变组织的病理变化,在预测肿瘤疗效方面发挥重要作用,在此基础上发展的影像组学进一步提高了预测的准确性。本文对IVIM和DCE-MRI技术进行简单介绍,并重点讨论这两种MRI影像征象及相关影像组学预测NPC疗效的研究现状,以及在临床实践中面临的主要限制及未来的研究方向,探寻其影像生物标记物,为今后个体化治疗和改善患者预后提供客观依据。

Radiotherapy is the main and effective treatment for nasopharyngeal carcinoma(NPC).Reliable prediction of tumor treatment efficacy before radiotherapy can significantly optimize the treatment plans for NPC patients and prolong their survival time.Intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced MRI(DCE-MRI)can provide multiple indicators to quantitatively describe the diffusion of water molecules and microcirculation perfusion information of tissue,which reflect the pathological changes of the lesion microscopically,and thereby contribute to the prediction of tumor treatment efficacy.The radiomics developed on them further improves the accuracy of prediction.We briefly introduced IVIM and DCE-MRI techniques,and focused on the current research status of these two MRI imaging features and related radiomics for predicting the treatment efficacy of NPC,as well as the main limitations and future research directions of each technology in clinical practice.Exploring the potential imaging biomarkers,IVIM and DCE-MRI will provide an objective foundation for personalized treatment and improve patient prognosis in the future.