Objective:To monitor tumor blood flow(TBF)before and after induction chemotherapy in locally advanced nasopharyngeal carcinoma(LA-NPC)by arterial spin labeling magnetic resonance imaging(ASL-MRI),and to investigate the value of ASL-MRI in early predicting response of induction chemotherapy and short-term efficacy in LA-NPC.Methods:Thirty-eight newly diagnosed LA-NPC patients were enrolled.ASL-MRI were performed both before and after induction chemotherapy to obtain Pre-TBF and Post-TBF.The TBF change value(ΔTBF)and the change rate(ΔTBF%)before and after induction chemotherapy were calculated.After in-duction chemotherapy,complete response(CR)and partial response(PR)were classified as response group(RG),and stable disease(SD)as well as progressive disease(PD)were classified as non-response group(NRG).The short-term efficacy was evaluated at 3 months after radiotherapy and divided into CR group and non-CR group(PR,SD and PD).Univariate and multivariate binary logistic regression analysis was used to evaluate the effects of TBF parameters on the response of induction chemotherapy and short-term efficacy.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy.Results:Of the 38 patients,23(60.5%)were in the RG and 15(39.5%)in the NRG.There were 22 cases(57.9%)in the CR group and 16 cases(42.1%)in the non-CR group at 3 months after radiotherapy.The CR rate at 3 months after radiotherapy was significantly higher in the RG than that in the NRG(73.9%vs.33.3%,P=0.02).Pre-TBF was significantly higher than Post-TBF in 38 patients(Z=4.227,P＜0.001).Pre-TBF,ΔTBF and ΔTBF%in the RG were significantly higher than that in the NRG(all P＜0.05);Pre-TBF,ΔTBF,and ΔTBF%were significantly higher in the CR group than that in the non-CR group at 3 months after radiotherapy(all P＜0.05).Multivariate binary logistic regression showed that Pre-TBF was an independent risk factor of the efficacy of induction chemotherapy(P=0.027),with the area under ROC curve(AUC)value of 0.745(P=0.012).T stage and ΔTBF%were independent risk factors of short-term efficacy(all P＜0.05),and the AUC value of ΔTBF%was 0.807(P=0.001).Conclusion:Pre-treatment TBF hyperperfusion in LA-NPC suggests better outcomes.Pre-TBF and ΔTBF%can predict the efficacy of induction chemotherapy and short-term efficacy of LA-NPC,respectively.
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