Histogram analysis of ADC in rectal cancer: associations with different histopathological findings including expression of EGFR, Hif1-alpha, VEGF, p53, PD1, and KI 67. A preliminary study

Abstract

Functional imaging modalities like Diffusion-weighted imaging are increasingly used to predict tumor behavior like cellularity and vascularity in different tumors. Histogram analysis is an emergent imaging analysis, in which every voxel is used to obtain a histogram and therefore statistically information about tumors can be provided. The purpose of this study was to elucidate possible associations between ADC histogram parameters and several immunhistochemical features in rectal cancer. Overall, 11 patients with histologically proven rectal cancer were included into the study. There were 2 (18.18%) females and 9 males with a mean age of 67.1 years. KI 67-index, expression of p53, EGFR, VEGF, and Hif1-alpha were semiautomatically estimated. The tumors were divided into PD1-positive and PD1-negative lesions. ADC histogram analysis was performed as a whole lesion measurement using an in-house matlab application.Spearman's correlation analysis revealed a strong correlation between EGFR expression and ADCmax (p=0.72, P=0.02). None of the vascular parameters (VEGF, Hif1-alpha) correlated with ADC parameters. Kurtosis and skewness correlated inversely with p53 expression (p=-0.64, P=0.03 and p=-0.81, P=0.002, respectively). ADCmedian and ADCmode correlated with Ki67 (p=-0.62, P=0.04 and p=-0.65, P=0.03, respectively). PD1-positive tumors showed statistically significant lower ADCmax values in comparison to PD1-negative tumors, 1.93 ± 0.36 vs 2.32 ± 0.47×10−3mm2/s, p=0.04.Several associations were identified between histogram parameter derived from ADC maps and EGFR, KI 67 and p53 expression in rectal cancer. Furthermore, ADCmax was different between PD1 positive and PD1 negative tumors indicating an important role of ADC parameters for possible future treatment prediction.

Combined Metabolo-Volumetric Parameters of 18F-FDG-PET and MRI Can Predict Tumor Cellularity, Ki67 Level and Expression of HIF 1alpha in Head and Neck Squamous Cell Carcinoma: A Pilot Study

“…In the used bottom-up approach, the whole sample was acquired at high resolution. Via Pannoramic Viewer 1.15.4 (open source software, 3D HISTECH Ltd., Budapest, Hungary) the slides were evaluated and three captures with a magnification of x200 were extracted of each sample as reported previously [20] .…”

Association Between VEGF Expression and Diffusion Weighted Imaging in Several Tumors—A Systematic Review and Meta-Analysis

“…However, as mentioned above, there are inconclusive results regarding possible associations between ADC and VEGF expression [17,22,24]. Hypothetically, a positive correlation between the parameters may exist.…”

“…After thorough review 14 articles were suitable for the present meta-analysis [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for the research [31].…”

Diagnostic Efficacy of Signal Intensity Ratio and Apparent Diffusion Coefficient Measurements in Differentiating Cerebellopontine Angle Meningioma and Schwannoma

“…Low intratumoral ADC values are related to high cellularity (11). Furthermore, ADC values derived from various measurement methods (predominantly histogram analysis based parameters) had shown their potential in reflecting many histopathological features in different tumors (17,18,(28)(29)(30)(31). Meningiomas have a relatively higher density of tumor cells and high nucleus/cytoplasm ra- SIR was calculated by measuring the ratio of mean tumoral signal intensity of CPA meningioma and schwannoma to the intensity of occipital subcutaneous adipose tissue in T2WI.…”