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Review | Open Access

Review of functional magnetic resonance imaging in the assessment of nasopharyngeal carcinoma treatment response

Kwun Lam Wong1,2, Ka Hei Cheng1, Sai Kit Lam1, Chenyang Liu1, Jing Cai1( )
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, People’s Republic of China
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, HKSH Medical Group, Hong Kong SAR, People’s Republic of China
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Abstract

Nasopharyngeal carcinoma (NPC) is a common malignancy endemic in South-East Asia. Functional magnetic resonance imaging (fMRI) has been used for prompt detection of treatment response before visible morphological changes in NPC treatment. Among different fMRI techniques, diffusion-weighted imaging (DWI) and dynamic contrast enhancement (DCE) were proved to be more successful in NPC treatment response assessment whilst the application of magnetic resonance spectroscopy (MRS) remains questionable. Apart from discussing the imaging technique, time points for post-treatment response assessments are recommended. Four instead of three months is recommended for prompt identification of non- or partial responders and 6–9 months post-treatment multiparametric MRI is also recommended for effective confirmation of complete responding individuals to avoid residual disease. For future advancement, in addition to the post-treatment response assessment, continuous or longitudinal assessment on the treatment response with the use of magnetic resonance simulator (MR-simulator) or magnetic resonace imaging guided linear accelerator (MR-Linac) tailor-made for radiotherapy (RT) maybe feasible. Longitudinal assessments or predictive radiomics modeling allow spotting out the possibility of treatment failure before the completion or even before the start of treatments. Adaptive instead of salvage treatments can then be prepared, thus reducing the damage and side effects of consecutive cytotoxic treatments.

Keywords

radiotherapynasopharyngeal carcinomafunctional MRItreatment response assessment

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Precision Radiation Oncology
Volume 6 Issue 2,
June 2022
Pages 177-185
DOI: 10.1002/pro6.1161
Cite this article:
Wong KL, Cheng KH, Lam SK, et al. Review of functional magnetic resonance imaging in the assessment of nasopharyngeal carcinoma treatment response. Precision Radiation Oncology, 2022, 6(2): 177-185. https://doi.org/10.1002/pro6.1161

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Received: 15 March 2022
Revised: 29 April 2022
Accepted: 04 May 2022
Published: 30 May 2022
© 2022 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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