Bollen Heleen, Dok Rüveyda, De Keyzer Frederik, Deschuymer Sarah, Laenen Annouschka, Devos Johannes, Vandecaveye Vincent, Nuyts Sandra
Laboratory of Experimental Radiotherapy, Department of Oncology, University of Leuven, 3000 Leuven, Belgium.
Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium.
Cancers (Basel). 2024 Dec 23;16(24):4284. doi: 10.3390/cancers16244284.
This study aimed to explore the differences in quantitative diffusion-weighted (DW) MRI parameters in oropharyngeal squamous cell carcinoma (OPC) based on Human Papillomavirus (HPV) status before and during radiotherapy (RT).
Echo planar DW sequences acquired before and during (chemo)radiotherapy (CRT) of 178 patients with histologically proven OPC were prospectively analyzed. The volumetric region of interest (ROI) was manually drawn on the apparent diffusion coefficient (ADC) map, and 105 DW-MRI radiomic parameters were extracted. Change in ADC values (Δ ADC) was calculated as the difference between baseline and during RT at week 4, normalized by the baseline values.
Pre-treatment first-order 10th percentile ADC and Gray Level co-occurrence matrix (GLCM)-correlation were significantly lower in HPV-positive compared with HPV-negative tumors (82.4 × 10 mm/s vs. 90.3 × 10 mm/s, = 0.03 and 0.18 vs. 0.30, < 0.01). In the fourth week of RT, all first-order ADC values were significantly higher in HPV-positive tumors ( < 0.01). Δ ADC mean was significantly higher for the HPV-positive compared with the HPV-negative OPC group (95% vs. 55%, < 0.01). A predictive model for HPV status based on smoking status, alcohol consumption, GLCM correlation, and mean ADC and 10th percentile ADC values yielded an area under the curve of 0.77 (95% CI 0.70-0.84).
Our results highlight the potential of DW-MR imaging as a non-invasive biomarker for the prediction of HPV status, although its current role remains supplementary to pathological confirmation.
本研究旨在探讨基于人乳头瘤病毒（HPV）状态的口咽鳞状细胞癌（OPC）在放疗（RT）前及放疗期间定量扩散加权（DW）MRI参数的差异。
前瞻性分析178例经组织学证实为OPC患者在（化疗）放疗（CRT）前及放疗期间采集的回波平面DW序列。在表观扩散系数（ADC）图上手动绘制感兴趣体积区域（ROI），并提取105个DW-MRI影像组学参数。ADC值变化（ΔADC）计算为第4周放疗基线值与放疗期间值的差值，并以基线值进行标准化。
与HPV阴性肿瘤相比，HPV阳性肿瘤治疗前的一阶第10百分位数ADC和灰度共生矩阵（GLCM）相关性显著更低（82.4×10⁻⁶mm²/s vs. 90.3×10⁻⁶mm²/s，P = 0.03；0.18 vs. 0.30，P < 0.01）。在放疗第4周，HPV阳性肿瘤的所有一阶ADC值均显著更高（P < 0.01）。与HPV阴性OPC组相比，HPV阳性组的ΔADC平均值显著更高（95% vs. 55%，P < 0.01）。基于吸烟状态、饮酒量、GLCM相关性、平均ADC和第10百分位数ADC值建立的HPV状态预测模型的曲线下面积为0.77（95%CI 0.70 - 0.84）。
我们的结果突出了DW-MR成像作为预测HPV状态的非侵入性生物标志物的潜力，尽管其目前的作用仍为病理确诊的补充手段。
