Contrast-enhanced dynamic and diffusion-weighted magnetic resonance imaging at 3.0�T to assess early-stage�nasopharyngeal carcinoma

Abstract

Abstract. The present study aimed to assess early-stage nasopharyngeal carcinoma (NPC) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) at 3.0 T. A total of 44 patients newly diagnosed with NPC were included in the present study. All patients underwent MR examination at 3.0 T using DCE-MRI and DWI. The volume transfer constant (K trans ), flux rate constant between extravascular extracellular space and plasma (K ep ), the volume of extravascular extracellular space per unit volume of tissue (V e ) and the apparent diffusion coefficient (ADC) of tumours were investigated. Furthermore, the correlation between clinical stages and ADC value and K trans were analysed. The diagnostic accuracy of K trans and ADC were estimated using receiver operating characteristic curves. NPC stage correlated positively with K trans and negatively with ADC values. Additionally, tumour K trans negatively correlated with ADC value. The sensitivity and accuracy of combined K trans and ADC in distinguishing between stage II and stage III and stage III and IV were higher than the values of either measurement used separately. The present study suggested that K trans and ADC derived from DCE-MRI and DWI may be useful to detect stage early NPC accurately. K trans and ADC in combination were superior than either alone. IntroductionAmong head and neck cancers, nasopharyngeal carcinoma (NPC) has a distinct natural history, aetiology, histopathology, and epidemiology. Male and female incidence of approximately 3:1. Most patients diagnosed with NPC tend to present with stage III or IV disease as a result of its deep location and vague symptoms (1-3). Radiation therapy and chemoradiotherapy are the primary methods of treatment (4), and are administered according to the clinical stage (5), making early diagnosis and staging crucial.Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven useful in characterization of tumour microcirculation and microvascular density. It can delineate the tumour margin from the surrounding tissues (6). DCE-MRI was proved useful in field of differential diagnosis benign and malignant tumours, correlation with tumour grade and stage, early prediction response, and outcome to chemotherapy, radiotherapy and antiangiogenic therapy. Diffusion-weighted imaging (DWI) can indirectly reflect the cell density and microstructure of living tissue (7). Magnetic resonance imaging may be the most powerful and versatile modality in the field of oncology for staging, predicting of treatment response, and identifying disease relapse, particularly in head and neck cancer (8-13). Over-staging and under-staging are the drawbacks of both methods. Various previous studies on bladder and breast cancer demonstrated that the sensitivity and accuracy could be increased by using 15). To the best of our knowledge, no study has combined DCE-MRI and DWI together in the diagnosis and staging of early NPC patients. The purpose of the present study was to explore the feasibility...

Quantitative Multiparametric MRI as an Imaging Biomarker for the Prediction of Breast Cancer Receptor Status and Molecular Subtypes

“…In addition,K ep was the highest in HER-2-enriched BC and the lowest in luminal A. This finding was consistent with the results of previous studies that indicated that more aggressive tumors have a higher K ep value (21).…”

Correlations of tumour permeability parameters with apparent diffusion coefficient in nasopharyngeal carcinoma

“…Despite this, our findings are in line with several prior studies supporting the hypothesis that proliferative tumours with higher cellularity are likely to have higher vascular permeability. Ni, Liu [13] reported in their study for NPC with DCE-MRI and DW-MRI scans using a 3T MR scanner, that a negative correlation was found with K trans and ADC in their cohort. Our results support their findings regarding K trans and ADC correlation.…”

“…Studies have shown that baseline tumour plasma perfusion is predictive in chemotherapy treatment response for patients with head and neck cancers [10] , [11] . Studies have indicated that tumour permeability is associated with the diffusivity and clinical stage of NPC [12] , [13] .…”

Multiparametric positron emission tomography/magnetic resonance imaging in nasopharyngeal carcinoma

“…Conversely, DCE-MRI has emerged as a valuable technique for investigating the properties of tissue microvasculature. Using a 3.0 T MRI scanner, Ni and Liu[ 18 ] have reported negative correlations between ADC and DCE-MRI parameters ( K trans , k ep, or v e ) in 44 patients with NPC. In keeping with their findings, we identified a significant negative association between ADC and K trans or v e .…”