Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Clin Imaging. 2020 Oct;66:127-132. doi: 10.1016/j.clinimag.2020.05.007. Epub 2020 May 15.
To probe the utility of diffusion-weighted imaging (DWI) and 3D arterial spin labeling (ASL) in assessing the clinical stage of nasopharyngeal carcinoma (NPC).
This prospective study included sixty-five newly diagnosed NPC patients who underwent DWI and 3D ASL scans on a 3.0-T magnetic resonance imaging (MRI) system. The apparent diffusion coefficient (ADC) and the tumor blood flow (TBF) of NPC were measured. Tumors were classified as low or high T, N and American Joint Committee on Cancer (AJCC) stages. Student's t-test was used to evaluate the differences between tumors with low and high clinical stages. Pearson correlation analyses were performed to determine the correlation between MRI parameters and clinical stages. Receiver operating characteristic (ROC) curves were then used to evaluate diagnostic capability.
High T stage (T3/4) NPC showed significantly lower ADC (P = 0.000) and higher TBF (P = 0.003) and TBF (P = 0.008) values than low T stage (T1/2) NPC. High N stage (N2/3) NPC showed significantly lower ADC values (P = 0.023) than low N stage (N0/1) NPC. High AJCC stage (III/IV) NPC showed significantly lower ADC (P = 0.000) and higher TBF (P = 0.005) and TBF (P = 0.011) values than low AJCC stage (I/II) NPC. ADC values showed moderate negative correlations with T stage (r = -0.512, P = 0.000), N stage (r = -0.281, P = 0.023), and AJCC stage (r = -0.494, P = 0.000). TBF values showed moderate positive correlations with T stage (r = 0.369, P = 0.003) and AJCC stage (r = 0.346, P = 0.005). Compared with ADC and TBF alone, the combination of ADC and TBF improved the accuracy from 72.3% and 75.4% to 78.5%, respectively, for T staging, as well as from 72.3% and 69.2% to 83.1% for AJCC staging.
ADC and TBF values in patients with NPC could help evaluate clinical stages. ADC and TBF values combined could clearly improve the accuracy in the assessment of AJCC stage.
探讨扩散加权成像（DWI）和三维动脉自旋标记（3D ASL）在评估鼻咽癌（NPC）临床分期中的应用价值。
本前瞻性研究纳入了 65 例新诊断的 NPC 患者，这些患者在 3.0T 磁共振成像（MRI）系统上接受了 DWI 和 3D ASL 扫描。测量 NPC 的表观扩散系数（ADC）和肿瘤血流（TBF）。肿瘤分为低 T、N 期和美国癌症联合委员会（AJCC）分期的高 T、N 期。采用 Student's t 检验比较低临床分期和高临床分期肿瘤之间的差异。采用 Pearson 相关分析确定 MRI 参数与临床分期之间的相关性。然后使用受试者工作特征（ROC）曲线评估诊断能力。
高 T 期（T3/4）NPC 的 ADC 值显著低于低 T 期（T1/2）NPC（P=0.000），TBF 值显著高于低 T 期 NPC（P=0.003）和 TBF 值显著高于低 T 期 NPC（P=0.008）。高 N 期（N2/3）NPC 的 ADC 值显著低于低 N 期（N0/1）NPC（P=0.023）。高 AJCC 期（III/IV）NPC 的 ADC 值显著低于低 AJCC 期（I/II）NPC（P=0.000），TBF 值显著高于低 AJCC 期 NPC（P=0.005）和 TBF 值显著高于低 AJCC 期 NPC（P=0.011）。ADC 值与 T 分期（r=-0.512，P=0.000）、N 分期（r=-0.281，P=0.023）和 AJCC 分期（r=-0.494，P=0.000）呈中度负相关。TBF 值与 T 分期（r=0.369，P=0.003）和 AJCC 分期（r=0.346，P=0.005）呈中度正相关。与 ADC 和 TBF 单独相比，ADC 和 TBF 的组合分别将 T 分期的准确性从 72.3%和 75.4%提高到 78.5%，AJCC 分期的准确性从 72.3%和 69.2%提高到 83.1%。
NPC 患者的 ADC 和 TBF 值有助于评估临床分期。ADC 和 TBF 值联合应用可显著提高 AJCC 分期评估的准确性。
