Combination of diffusion-weighted imaging and arterial spin labeling at 3.0 T for the clinical staging of nasopharyngeal carcinoma

Bohan Xiao; Peiguo Wang; Yingru Zhao; Ying Liu; Zhaoxiang Ye

doi:10.1016/j.clinimag.2020.05.007

Combination of diffusion-weighted imaging and arterial spin labeling at 3.0 T for the clinical staging of nasopharyngeal carcinoma

Clin Imaging. 2020 Oct:66:127-132. doi: 10.1016/j.clinimag.2020.05.007. Epub 2020 May 15.

Authors

Bohan Xiao¹, Peiguo Wang², Yingru Zhao¹, Ying Liu¹, Zhaoxiang Ye³

Affiliations

¹ 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.
² 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.
³ 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. Electronic address: yezhaoxiang@163.com.

PMID: 32480267
DOI: 10.1016/j.clinimag.2020.05.007

Abstract

Purpose: To probe the utility of diffusion-weighted imaging (DWI) and 3D arterial spin labeling (ASL) in assessing the clinical stage of nasopharyngeal carcinoma (NPC).

Materials and methods: 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.

Results: High T stage (T3/4) NPC showed significantly lower ADC_min (P = 0.000) and higher TBF_max (P = 0.003) and TBF_mean (P = 0.008) values than low T stage (T1/2) NPC. High N stage (N2/3) NPC showed significantly lower ADC_min values (P = 0.023) than low N stage (N0/1) NPC. High AJCC stage (III/IV) NPC showed significantly lower ADC_min (P = 0.000) and higher TBF_max (P = 0.005) and TBF_mean (P = 0.011) values than low AJCC stage (I/II) NPC. ADC_min 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_max 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_min and TBF_max alone, the combination of ADC_min and TBF_max 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.

Conclusions: ADC_min and TBF_max values in patients with NPC could help evaluate clinical stages. ADC_min and TBF_max values combined could clearly improve the accuracy in the assessment of AJCC stage.

Keywords: Arterial spin labeling; Clinical stage; Diffusion-weighted imaging; Magnetic resonance imaging; Nasopharyngeal carcinoma.

MeSH terms

Adult
Aged
Diffusion Magnetic Resonance Imaging / methods
Female
Humans
Magnetic Resonance Imaging / methods
Male
Middle Aged
Nasopharyngeal Carcinoma / diagnostic imaging*
Nasopharyngeal Neoplasms / diagnostic imaging*
Nasopharyngeal Neoplasms / pathology
Neoplasm Staging*
Prospective Studies
ROC Curve
Spin Labels

Substances

Spin Labels