Fujima Noriyuki, Shimizu Yukie, Yoneyama Masami, Nakagawa Junichi, Kameda Hiroyuki, Harada Taisuke, Hamada Seijiro, Suzuki Takayoshi, Tsushima Nayuta, Kano Satoshi, Homma Akihiro, Kudo Kohsuke
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Quant Imaging Med Surg. 2022 Aug;12(8):4024-4032. doi: 10.21037/qims-22-136.
In head and neck cancers, histopathological information is important for the determination of the tumor characteristics and for predicting the prognosis. The aim of this study was to assess the utility of diffusion-weighted T2 (DW-T2) mapping for the evaluation of tumor histological grade in patients with head and neck squamous cell carcinoma (SCC).
The cases of 41 patients with head and neck SCC (21 well/moderately and 17 poorly differentiated SCC) were retrospectively analyzed. All patients received MR scanning using a 3-Tesla MR unit. The conventional T2 value, DW-T2 value, ratio of DW-T2 value to conventional T2 value, and apparent diffusion coefficient (ADC) were calculated using signal information from the DW-T2 mapping sequence with a manually placed region of interest (ROI).
ADC values in the poorly differentiated SCC group were significantly lower than those in the moderately/well differentiated SCC group (P<0.05). The ratio of DW-T2 value to conventional T2 value was also significantly different between poorly and moderately/well differentiated SCC groups (P<0.01). Receiver operating characteristic (ROC) curve analysis of ADC values showed a sensitivity of 0.76, specificity of 0.67, positive predictive value (PPV) of 0.62, negative predictive value (NPV) of 0.8, accuracy of 0.71 and area under the curve (AUC) of 0.73, whereas the ROC curve analysis of the ratio of DW-T2 value to conventional T2 value showed a sensitivity of 0.76, specificity of 0.83, PPV of 0.76, NPV of 0.83, accuracy of 0.8 and AUC of 0.82.
DW-T2 mapping might be useful as supportive information for the determination of tumor histological grade in patients with head and neck SCC.
在头颈癌中，组织病理学信息对于确定肿瘤特征和预测预后至关重要。本研究的目的是评估扩散加权T2（DW-T2）成像在评估头颈部鳞状细胞癌（SCC）患者肿瘤组织学分级中的应用价值。
回顾性分析41例头颈部SCC患者的病例（21例高/中分化SCC和17例低分化SCC）。所有患者均使用3特斯拉磁共振设备进行磁共振扫描。使用来自DW-T2成像序列的信号信息和手动放置的感兴趣区域（ROI）计算常规T2值、DW-T2值、DW-T2值与常规T2值的比值以及表观扩散系数（ADC）。
低分化SCC组的ADC值显著低于中/高分化SCC组（P<0.05）。低分化与中/高分化SCC组之间DW-T2值与常规T2值的比值也有显著差异（P<0.01）。ADC值的受试者操作特征（ROC）曲线分析显示，敏感性为0.76，特异性为0.67，阳性预测值（PPV）为0.62，阴性预测值（NPV）为0.8，准确性为0.71，曲线下面积（AUC）为0.73；而DW-T2值与常规T2值比值的ROC曲线分析显示，敏感性为0.76，特异性为0.83，PPV为0.76，NPV为0.83，准确性为0.8，AUC为0.82。
DW-T2成像可能作为确定头颈部SCC患者肿瘤组织学分级的辅助信息。
