Using arterial spin labeling blood flow and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma from lymphoid hyperplasia

Abstract

To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH). Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann–Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis. The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05). ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.

The utility of texture analysis based on quantitative synthetic magnetic resonance imaging in nasopharyngeal carcinoma: a preliminary study

“…First-order features and analysis, which are relatively easier to understand and implement compared with radiomics, reflect the distribution of voxel intensity with high reproducibility [19,20]. Previous studies [21][22][23][24] showed that whole-tumour first-order features, such as Skewness, Variance and so on, can potentially be used for diagnosis and survival prediction in NPC. The research in SyMRI demonstrated that Mean value could help in discriminating NPC from NPH, but the test-retest repeatability and tumour heterogeneity were not evaluated [13].…”

Clinical indications and acquisition protocol for the use of dynamic contrast-enhanced MRI in head and neck cancer squamous cell carcinoma: recommendations from an expert panel

“…Among these, perfusion weighted MR imaging (PWI) allows to assess cancer tissue vascular properties and has the potential to significantly improve the accuracy of MRI in HNSCC evaluation both for diagnosis and prognosis [ 6 ]. Dynamic contrast enhanced (DCE) MRI, based on the serial acquisition of multiple T1-weighted images before, during and after the intravenous injection of a Gd-based contrast agent, is the most frequently used perfusion technique for H&N region, though other perfusion techniques such as dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) have been proposed [ 7 – 9 ]. The rationale for using PWI in HNSCCs evaluation lies in the possibility of evaluating tumor neoangiogenesis.…”