Meyer Hans Jonas, Leifels Leonard, Schob Stefan, Garnov Nikita, Surov Alexey
Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
Department of Neuroradiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
Magn Reson Imaging. 2018 Jan;45:72-77. doi: 10.1016/j.mri.2017.09.015. Epub 2017 Sep 28.
Nowadays, multiparametric investigations of head and neck squamous cell carcinoma (HNSCC) are established. These approaches can better characterize tumor biology and behavior. Diffusion weighted imaging (DWI) can by means of apparent diffusion coefficient (ADC) quantitatively characterize different tissue compartments. Dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) reflects perfusion and vascularization of tissues. Recently, a novel approach of data acquisition, namely histogram analysis of different images is a novel diagnostic approach, which can provide more information of tissue heterogeneity. The purpose of this study was to analyze possible associations between DWI, and DCE parameters derived from histogram analysis in patients with HNSCC.
Overall, 34 patients, 9 women and 25 men, mean age, 56.7±10.2years, with different HNSCC were involved in the study. DWI was obtained by using of an axial echo planar imaging sequence with b-values of 0 and 800s/mm. Dynamic T1w DCE sequence after intravenous application of contrast medium was performed for estimation of the following perfusion parameters: volume transfer constant (K), volume of the extravascular extracellular leakage space (Ve), and diffusion of contrast medium from the extravascular extracellular leakage space back to the plasma (Kep). Both ADC and perfusion parameters maps were processed offline in DICOM format with custom-made Matlab-based application. Thereafter, polygonal ROIs were manually drawn on the transferred maps on each slice. For every parameter, mean, maximal, minimal, and median values, as well percentiles 10th, 25th, 75th, 90th, kurtosis, skewness, and entropy were estimated.
Сorrelation analysis identified multiple statistically significant correlations between the investigated parameters. Ve related parameters correlated well with different ADC values. Especially, percentiles 10 and 75, mode, and median values showed stronger correlations in comparison to other parameters. Thereby, the calculated correlation coefficients ranged from 0.62 to 0.69. Furthermore, K related parameters showed multiple slightly to moderate significant correlations with different ADC values. Strongest correlations were identified between ADC P75 and K min (p=0.58, P=0.0007), and ADC P75 and K P10 (p=0.56, P=0.001). Only four K related parameters correlated statistically significant with ADC fractions. Strongest correlation was found between K max and ADC mode (p=-0.47, P=0.008).
Multiple statistically significant correlations between, DWI and DCE MRI parameters derived from histogram analysis were identified in HNSCC.
目前，头颈部鳞状细胞癌（HNSCC）的多参数研究已确立。这些方法能够更好地表征肿瘤生物学特性和行为。扩散加权成像（DWI）可通过表观扩散系数（ADC）定量表征不同组织成分。动态对比增强磁共振成像（DCE MRI）反映组织的灌注和血管化情况。最近，一种新的数据采集方法，即不同图像的直方图分析，是一种新型诊断方法，可提供更多关于组织异质性的信息。本研究的目的是分析HNSCC患者中DWI以及源自直方图分析的DCE参数之间可能存在的关联。
本研究共纳入34例患者，其中女性9例，男性25例，平均年龄56.7±10.2岁，患有不同类型的HNSCC。使用b值为0和800 s/mm的轴向回波平面成像序列获取DWI。静脉注射造影剂后进行动态T1w DCE序列，以评估以下灌注参数：容积转运常数（K）、血管外细胞外渗漏空间容积（Ve）以及造影剂从血管外细胞外渗漏空间回渗至血浆的扩散率（Kep）。ADC图和灌注参数图均以DICOM格式通过基于Matlab的定制应用程序进行离线处理。此后在每个切片的传输图像上手动绘制多边形感兴趣区（ROI）。对于每个参数，估计其均值、最大值、最小值、中位数以及第10、25、75、90百分位数、峰度、偏度和熵。
相关性分析确定了所研究参数之间存在多个具有统计学意义的相关性。Ve相关参数与不同的ADC值相关性良好。特别是，第10和75百分位数、众数和中位数与其他参数相比显示出更强的相关性。由此计算出的相关系数范围为0.62至0.69。此外，K相关参数与不同的ADC值显示出多个轻度至中度的显著相关性。ADC第75百分位数与K最小值（p = 0.58，P = 0.0007）以及ADC第75百分位数与K第10百分位数（p = 0.56，P = 0.001）之间的相关性最强。只有四个K相关参数与ADC分数具有统计学意义的相关性。K最大值与ADC众数之间的相关性最强（p = -0.47，P = 0.008）。
在HNSCC中，DWI与源自直方图分析的DCE MRI参数之间存在多个具有统计学意义的相关性。
