Evidence map›Paper›PMID 40745603›Full record

ArticleBMC medical imaging2025

The use of diffusion-weighted magnetic resonance imaging and parametric response mapping for disease outcome prediction in nasopharyngeal carcinoma.

Akarapong Teeraakaravipas, Napat Ritlumlert, Yothin Rakvongthai, Tunchanok Paprad, Chawalit Lertbutsayanukul, Nutchawan Jittapiromsak

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Article in BMC medical imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Akarapong TeeraakaravipasDivision of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Napat RitlumlertChulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Yothin RakvongthaiChulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Tunchanok PapradDivision of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Chawalit LertbutsayanukulDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Nutchawan JittapiromsakDivision of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand. nutchawan.j@chula.ac.th.ORCID 0000-0002-0861-2162

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNasopharyngeal carcinoma (NPC) shows variable treatment responses due to tumor heterogeneity and individual radiosensitivity, complicating the early identification of patients at risk for recurrence. Developing reliable imaging biomarkers could help predict treatment outcomes, enabling timely treatment adjustments and improved prognosis. Therefore, we aimed to evaluate the use of the apparent diffusion coefficient (ADC), based on diffusion-weighted imaging, and parametric response mapping (PRM), a voxel-wise imaging analysis method, in predicting treatment outcomes of patients with NPC.

methodsThis retrospective and prospective cohort study included 70 patients with NPC, treated with radiotherapy or concurrent chemoradiation therapy with or without induction chemotherapy. Imaging examinations were performed before (pre-treatment) and 5 weeks after initiating treatment (intra-treatment). Tumor volume at pre- and intra-treatment, percentage change in tumor volume (%∆Vol), pre- and intra-treatment ADC, percentage change in ADC (%∆ADC), and voxels with increased ADC values within the tumor (PRM+) were used to predict correlation with treatment outcomes. Poor outcomes were defined as developing locoregional recurrence, distant metastases, or death. The primary endpoint was progression-free survival, defined as the time to these events. Kaplan-Meier survival analysis, Cox regression, and multivariate models were used to determine predictive factors.

resultsOverall, 17 and 53 patients had poor and good outcomes, respectively. The PRM+ was lower in patients with poor outcomes than in those with good outcomes (22.4% vs. 64.1%; p < 0.001). In the multivariate analyses, cut-off values of PRM+ < 35% and initial T-stage 3-4 were identified as two risk factors associated with poor outcomes, with adjusted hazard ratios (95% confidence intervals) of 22.53 (5.09-99.8; p < 0.001), and 3.45 (1.10-10.77; p = 0.033), respectively.

conclusionsLow PRM+ and high initial T-stage were associated with poor treatment outcomes. Therefore, PRM+ can be a predictive tool for NPC treatment outcomes. Integrating PRM into clinical practice could enhance individualized treatment planning, leading to better patient outcomes and reduced treatment-related side effects.

Indexed as

Diffusion Magnetic Resonance ImagingNasopharyngeal CarcinomaNasopharyngeal NeoplasmsAdultAgedChemoradiotherapyFemaleHumansMaleMiddle AgedPrognosisProspective StudiesRetrospective StudiesTreatment OutcomeTumor BurdenApparent diffusion coefficientDiffusion-weighted imagingNasopharyngeal carcinomaParametric response mapTreatment prediction

Identifiers

PMID40745603
PMCPMC12315438

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.