Study Of MRI On Non-surgical Laryngeal And Hypopharygeal Carcinomapatients Pre- And Post-chemoradiotherapy

Part Ⅰ Clinical value of follow-up MRI for non-surgical laryngeal and hypopharyngeal carcinoma patients pre-and post-chemoradiotherapyObjective:To explore the clinical value of follow-up MRI for non-surgical laryngeal and hypopharyngeal carcinoma patients pre-and post-chemoradiotherapy.Methods:Twenty five non-surgical cases of laryngeal or hypopharyngeal squamous cell carcinoma, which were confirmed pathologically underwent routine contrast-enhanced MRI examination prior to and 3,6,9,12 months after chemoradiotherapy. The change of the largest area of primary lesion was compared. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the non-tumor tissue on T2WI was measured to evaluate the edema status.Results:The largest area of the primary lesion obviously decreased in all patients (P<0.05). During the follow-up, the primary lesion couldn’t be detected in 17 cases at the 3rd-month MRI, in 4 cases at the 6th-month MRI and in 4 cases at the 9th-month MRI, respectively. The SNR of the non-tumor tissue shows no significant differences between pre-therapy and the 3rd-month MR scan. The SNR for the other time points and CNR for all the time points of the non-tumor tissue afterthe therapy were significantly higher than that of pre-therapy (P<0.05).Conclusion MRI can clearly detect the change of the primary lesion of laryngeal and hypopharyngeal carcinoma. Most lesions couldn’t be detected within 3 months after the therapy. SNR and CNR are helpful for observing the change of non-tumor tissue edema.Part Ⅱ The value of diffusion-weighted imaging for clinical evaluation of chemoradiotherapy of non-surgical laryngeal and hypopharyngeal carcinoma patientsAbstractObjective:To investigate the value of the magnetic resonance diffusion weighted imaging combined with conventional MRI for predicting clinical effect of chemoradiotherapy in non-surgical laryngeal and hypopharyngeal carcinoma.Materials and Methods:A total of 25 cases of patients with non-surgical laryngeal and hypopharyngeal carcinoma, which was confirmed by biopsy or surgical pathology, were included. All patients underwent conventional MRI and DWI scan for pre-and post-treatment. The maximum cross sectional area and apparent diffusion coefficient (ADC) value (the mean, the highest and lowest ADC value) of the tumor were measured before treatment. The residual tumor size and ADC values were measured after treatment, and tumor regression rate was calculated. The differences of ADC values with complete response (CR) and non-CR before and after treatment were analyzed.Results:The maximum cross sectional area (2.42 (0～7.92) cm2 of the tumor after treatment was significantly reduced (P<0.05) than that from pre-treatment(4.81 (0.83～14.12) cm2). The total tumor remission rate was 74.8%(6.0%-100%)and CR was in 11 (11/25,44.0%) patients. Pre-treatment ADCmean and the highest ADC value were negatively correlated with the rate of tumor regression (r=-0.922,-0.691,P<0.05), and post-treatment ADCmean value was positively correlated with the regression rate (P<0.05, r=0.678). Pre-treatment ADCmean and ADChigh values in non CR group were higher than those in the CR group. Post-treatment ADCmean value and differences of the ADC value between pre-and post-treatment of CR group were significantly higher than those of non CR group (P<0.05).Conclusions:The pre-treatment ADC values and the differences of the ADC value between pre-and post-treatment might be useful to predict and evaluate the response of radiotherapy and chemotherapy in the non-surgical laryngeal and hypopharyngeal carcinoma patients.