三维化学交换饱和转移（3D CEST）技术是一种新颖且有前景的磁共振序列，然而其在鼻咽癌（NPC）中的应用缺乏足够的评估。本研究旨在评估3D CEST技术在NPC患者化学放射治疗（CRT）短期治疗结果预测中的可行性。40名NPC患者和14名健康志愿者纳入并接受预处理3D CEST磁共振成像和弥散加权成像（DWI）。通过计算酰胺质子转移加权信号强度（APTw-SI）和磁化转移比率（MTR）值的健康志愿者内部和间隔观察者相关系数（ICC），评估3D CEST的可靠性。基于CRT后短期治疗结果，将NPC患者分为残留组和非残留组。手动绘制整个肿瘤感兴趣区域（ROIs）以测量APTw-SI、MTR和显性扩散系数（ADC）值。采用多变量分析和接收器操作特征曲线（ROC）评估临床特征、APTw-SI、MTR、ADC值和组合模型在预测NPC患者短期治疗结果方面的预测性能。对于健康志愿者组，所有APTw-SI和MTR值的内部和间隔观察者一致性良好至优秀（0.736-0.910，0.895-0.981，所有P>0.05）。对于NPC患者，MTR值在非残留组和残留组之间显示出显著差异（31.24±5.21% vs. 34.74±1.54%，P=0.003），而APTw-SI和ADC值没有显著差异（P>0.05）。此外，MTR值的诊断能力优于APTw-SI（AUC：0.818 vs. 0.521，P=0.017），与ADC值相当（AUC：0.818 vs. 0.649，P>0.05），用于预测NPC患者短期治疗结果。即使将MTR值与APTw-SI和/或ADC值结合使用，预测性能也没有改善（P>0.05）。通过3D CEST获取的预处理MTR值在NPC患者CRT后的短期治疗结果预测中表现出优越的预测性能，相比之下，APTw-SI和ADC值较低。© 2023. International Cancer Imaging Society (ICIS).

The three-dimensional chemical exchange saturation transfer (3D CEST) technique is a novel and promising magnetic resonance sequence; however, its application in nasopharyngeal carcinoma (NPC) lacks sufficient evaluation. This study aimed to assess the feasibility of the 3D CEST technique in predicting the short-term treatment outcomes for chemoradiotherapy (CRT) in NPC patients.Forty NPC patients and fourteen healthy volunteers were enrolled and underwent the pre-treatment 3D CEST magnetic resonance imaging and diffusion-weighted imaging (DWI). The reliability of 3D CEST was assessed in healthy volunteers by calculating the intra- and inter-observer correlation coefficient (ICC) for amide proton transfer weighted-signal intensity (APTw-SI) and magnetization transfer ratio (MTR) values. NPC patients were divided into residual and non-residual groups based on short-term treatment outcomes after CRT. Whole-tumor regions of interest (ROIs) were manually drawn to measure APTw-SI, MTR and apparent diffusion coefficient (ADC) values. Multivariate analysis and the receiver operating characteristic curve (ROC) were used to evaluate the prediction performance of clinical characteristics, APTw-SI, MTR, ADC values, and combined models in predicting short-term treatment outcomes in NPC patients.For the healthy volunteer group, all APTw-SI and MTR values exhibited good to excellent intra- and inter-observer agreements (0.736-0.910, 0.895-0.981, all P > 0.05). For NPC patients, MTR values showed a significant difference between the non-residual and residual groups (31.24 ± 5.21% vs. 34.74 ± 1.54%, P = 0.003) while no significant differences were observed for APTw-SI and ADC values (P > 0.05). Moreover, the diagnostic power of MTR value was superior to APTw-SI (AUC: 0.818 vs. 0.521, P = 0.017) and comparable to ADC values (AUC: 0.818 vs. 0.649, P > 0.05) in predicting short-term treatment outcomes for NPC patients. The prediction performance did not improve even when combining MTR values with APTw-SI and/or ADC values (P > 0.05).The pre-treatment MTR value acquired through 3D CEST demonstrated superior predictive performance for short-term treatment outcomes compared to APTw-SI and ADC values in NPC patients after CRT.© 2023. International Cancer Imaging Society (ICIS).