Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
Department of Pathology, University of Leipzig, Leipzig, Germany.
Radiol Oncol. 2021 Jan 20;55(2):150-157. doi: 10.2478/raon-2021-0005.
Immunotherapy has become a cornerstone of the modern cancer treatment. It might be crucial to predict its expression non-invasively by imaging. The present study used diffusion-weighted imaging (DWI) quantified by whole lesion apparent diffusion coefficient (ADC) values to elucidate possible associations with programmed cell death ligand 1(PD-L1) expression in head and neck squamous cell cancer (HNSCC).
Overall, 29 patients with primary HNSCC of different localizations were involved in the study. DWI was obtained by using a sequence with b values of 0 and 800 s/mm on a 3 T MRI. ADC values were evaluated with a whole lesion measurement and a histogram approach. PD-L1 expression was estimated on bioptic samples before any form of treatment using 3 scores, tumor positive score (TPS), immune cell score (ICS), and combined positive score (CPS).
An inverse correlation between skewness derived from ADC values and ICS was identified (r = -0.38, p = 0.04). ADC tended to correlate with ICS (r = -0.35, p = 0.06). Other ADC parameters did not show any association with the calculated scores.
There is a weak association between skewness derived from ADC values and PD-L1 expression in HNSCC, which might not be strong enough to predict PD-L1 expression in clinical routine. Presumably, ADC values are more influenced by complex histopathology compartments, comprising cellular and extracellular aspects of tumors than only of a single subset of tumor associated cells.
免疫疗法已成为现代癌症治疗的基石。通过影像学对其进行非侵入性预测可能至关重要。本研究使用弥散加权成像（DWI）通过全病变表观弥散系数（ADC）值进行量化，以阐明其与头颈部鳞状细胞癌（HNSCC）中程序性死亡配体 1（PD-L1）表达的可能相关性。
共有 29 例不同部位原发性 HNSCC 患者参与了本研究。DWI 通过在 3T MRI 上使用 b 值为 0 和 800 s/mm 的序列获得。ADC 值通过全病变测量和直方图方法进行评估。PD-L1 表达在使用 3 种评分（肿瘤阳性评分（TPS）、免疫细胞评分（ICS）和联合阳性评分（CPS））进行任何治疗之前，通过活检样本进行评估。
从 ADC 值中得出的偏度与 ICS 呈负相关（r = -0.38，p = 0.04）。ADC 与 ICS 呈负相关趋势（r = -0.35，p = 0.06）。其他 ADC 参数与计算出的评分没有任何关联。
在 HNSCC 中，从 ADC 值中得出的偏度与 PD-L1 表达之间存在微弱的相关性，但这可能不足以在临床常规中预测 PD-L1 表达。据推测，ADC 值受肿瘤中包含细胞和细胞外方面的复杂组织病理学区室的影响比仅受肿瘤相关细胞的单一亚群的影响更大。
