Prognostic Value of the Pretreatment Primary Lesion Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Nasopharyngeal Carcinoma

Rationale and Objectives Early identifying the long-term outcome of chemoradiotherapy is helpful for personalized treatment in nasopharyngeal carcinoma (NPC). This study aimed to investigate the prognostic significance of pretreatment quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for NPC. Materials and Methods The relationships between the prognosis and pretreatment quantitative DCE-MRI (K trans , K ep , V e , and f pv ) values of the primary tumors were analyzed in 134 NPC patients who received chemoradiotherapy. Kaplan-Meier analysis was performed to calculate the local-regional relapse-free survival (LRRFS), local relapse-free survival (LRFS), regional relapse-free survival, distant metastasis-free survival (DMFS), progression-free survival, and overall survival rates. Cox proportional hazards model was used to explore the independent predictors for prognosis. Results The local-failure group had significantly higher V e ( p  = 0.033) and f pv values ( p  = 0.005) than the non-local-failure group. The V e-high group showed significantly lower LRRFS ( p  = 0.015) , LRFS ( p  = 0.013) , DMFS ( p  = 0.027) and progression-free survival ( p  = 0.035) rates than the V e-low group. The f pv-high group exhibited significantly lower LRRFS ( p  = 0.004) and LRFS ( p  = 0.005) rates than the f pv-low group. V e was the independent predictor for LRRFS ( p  = 0.008), LRFS ( p  = 0.007), DMFS ( p  = 0.041), and overall survival ( p  = 0.022). f pv was the independent indicator for LRRFS ( p  = 0.003) and LRFS ( p  = 0.001). Conclusion Baseline quantitative DCE-MRI may be valuable in predicting the prognosis for NPC.