Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Determining the Plasma Epstein-Barr Virus Status and Staging of Nasopharyngeal Carcinoma

Abstract

Objective: To determine the associations between dynamic-contrast enhanced (DCE) magnetic resonance imaging (MRI) parameters and plasma Epstein-Barr virus (EBV) DNA status and nasopharyngeal carcinoma (NPC) stages. Methods: We prospectively studied the DCE MRI results of 47 patients with newly diagnosed NPC and a known pre-treatment plasma EBV DNA level. Regions of interest (ROIs) were drawn at primary tumors, and DCE MRI parameters, including mean and max values of Ktrans, Kep Ve, and Vp, were recorded. Spearman’s rank correlation was used to identify significant associations between DCE MRI parameters and plasma EBV DNA level and NPC stages. Mann-Whitney U tests and unpaired t-test were performed to compare DCE MRI parameters among groups and to find optimal cut-off values using receiver operating characteristic curves. Results: DCE MRI parameters were correlated with plasma EBV DNA levels and NPC stages. Positive plasma EBV DNA was correlated with lower Kepmean (optimal cut-off value, 2.1 min⁻¹ ; area under the curve [AUC], 0.714) and higher Vemax (optimal cut-off value, 0.675; AUC, 0.706). Vemax higher than 0.765 (AUC, 0.678) was correlated with plasma EBV DNA (≥2,300 copies mlll⁻¹). Higher Ktransmax (cut-off value, 1.495 min⁻¹; AUC, 0.767) was correlated with high T stage, and higher Vpmean(cut-off value, 0.125; AUC, 0739) was correlated with positive lymph nodes. Ktransmax higher than 1.495 min⁻¹ (AUC, 0.711) was correlated with the high stage group. Conclusions: DCE MRI is correlated with the plasma EBV DNA status and NPC stages. Therefore, DCE MRI findings may be used as imaging biomarkers for NPC patients.