Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for pretreatment prediction of neoadjuvant chemotherapy response in locally advanced hypopharyngeal cancer

Objective:The aim of this study was to predict response to neoadjuvant chemotherapy (NAC) in patients with locally advanced hypopharyngeal cancer by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Methods:A retrospective study enrolled 46 diagnosed locally advanced hypopharyngeal cancer. DCE-MRI were performed prior to and after two cycles of NAC. The volume transfer constant (Ktrans), extracellular extravascular volume fraction (Ve), and plasma volume fraction (Kep) were computed from primary tumors. DCE-MRI parameters were used to measure tumor response according to the Response Evaluation Criteria in Solid Tumors criteria (RECIST).Results：After 2 NAC cycles, 30 out of 46 patients were categorized into the responder group, whereas the other 16 were categorized into non-responder group. Compared with the pretreatment value, the post-treatment Ktrans and Kep was significantly lower (P < 0.05), but no significant change in Ve (P > 0.05). Compared with non-responders, a notably higher pretreatment Ktrans, Kep, lower post-treatment Ktrans, higher ΔKtrans and ΔKep were observed in responders (all P < 0.05). While the pretreatment Ve, post-treatment Ve, and ΔVe did not differ significantly (P>0.05) between the two groups. The receiver operating characteristic curve analysis revealed that pretreatment Ktrans of 0.202/min is the most optimal cut-off in predicting response to chemotherapy, resulting in an AUC of 0.837 and corresponding sensitivity and specificity of 76.7%, and 81.1%, respectively.Conclusion:DCE-MRI especially pretreatment Ktrans can potentially predict the treatment response to neoadjuvant chemotherapy for hypopharyngeal cancer.Advances in knowledge:Few studies of DCE-MRI on hypopharyngeal cancer treated with chemoradiation reported. The results demonstrate that DCE-MRI especially pretreatment Ktrans may be more potential value in predicting the treatment response to neoadjuvant chemotherapy for hypopharyngeal cancer.