Role of Texture Analysis in Oropharyngeal Carcinoma: A Systematic Review of the Literature

Abstract

Human papilloma virus infection (HPV) is associated with the development of lingual and palatine tonsil carcinomas. Diagnosing, differentiating HPV-positive from HPV-negative cancers, and assessing the presence of lymph node metastases or recurrences by the visual interpretation of images is not easy. Texture analysis can provide structural information not perceptible to human eyes. A systematic literature search was performed on 16 February 2022 for studies with a focus on texture analysis in oropharyngeal cancers. We conducted the research on PubMed, Scopus, and Web of Science platforms. Studies were screened for inclusion according to the preferred reporting items for systematic reviews. Twenty-six studies were included in our review. Nineteen articles related specifically to the oropharynx and seven articles analysed the head and neck area with sections dedicated to the oropharynx. Six, thirteen, and seven articles used MRI, CT, and PET, respectively, as the imaging techniques by which texture analysis was performed. Regarding oropharyngeal tumours, this review delineates the applications of texture analysis in (1) the diagnosis, prognosis, and assessment of disease recurrence or persistence after therapy, (2) early differentiation of HPV-positive versus HPV-negative cancers, (3) the detection of cancers not visualised by imaging alone, and (4) the assessment of lymph node metastases from unknown primary carcinomas.

Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer

“…Because of the high-contrast resolution and the ability to study complex anatomical regions without the use of radiation, magnetic resonance imaging (MRI) is considered the most relevant imaging technique for the identification of head and neck lesions [16][17][18][19]. Diffusion-weighted imaging (DWI) is an established diagnostic tool that evaluates the tissue microanatomy by studying the spontaneous molecular diffusion of protons corresponding to the stochastic Brownian motion of water molecules [16,20,21].…”

“…The apparent diffusion coefficient (ADC) is calculated from DWI and consists of the quantitative assessment of the impedance of water molecule diffusion within tissues [20]. The ADC is typically reduced in hypercellular tissues and increased in situations where water molecules are free to move [16,17]. The ADC values are calculated automatically and integrated into a parametric map, upon which regions of interest (ROIs) can be traced at a workstation to determine the ADC values of specific portions of a tissue [16][17][18].…”

“…The ADC is typically reduced in hypercellular tissues and increased in situations where water molecules are free to move [16,17]. The ADC values are calculated automatically and integrated into a parametric map, upon which regions of interest (ROIs) can be traced at a workstation to determine the ADC values of specific portions of a tissue [16][17][18]. Dynamic contrastenhanced, perfusion-weighted imaging (DCE-PWI) is a functional MRI technique that allows one to infer blood perfusion to specific tissues by measuring the changes in tissues over time after the intravenous administration of a contrast agent [22].…”

“…Radiomics has been rapidly developing over the last few years; it is a hybrid analytical process aimed at determining the correlation between the characteristics of tissues and their corresponding digital images [17,27]. Texture analysis is a form of radiomics, in which macroscopic heterogeneities of tissues can be non-invasively studied to infer information about their microscopic architecture beyond the possibilities of the human eye as if it were a "virtual biopsy" [17,28,29].…”

“…Radiomics has been rapidly developing over the last few years; it is a hybrid analytical process aimed at determining the correlation between the characteristics of tissues and their corresponding digital images [17,27]. Texture analysis is a form of radiomics, in which macroscopic heterogeneities of tissues can be non-invasively studied to infer information about their microscopic architecture beyond the possibilities of the human eye as if it were a "virtual biopsy" [17,28,29]. Texture analysis is based on the extraction of parameters representing the distribution frequency, intensity, or direction of gray levels within the ROI in order to evaluate the single pixel, its interactions with adjacent pixels, and the distribution of pixels and voxels in the image [17,29].…”