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Differentiation between nasopharyngeal carcinoma and lymphoma at the primary site using whole-tumor histogram analysis of apparent diffusion coefficient maps

  • HEAD, NECK AND DENTAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Introduction

To determine the value of whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating nasopharyngeal carcinoma (NPC) from lymphoma (NPL) at the primary site

Method and materials

One hundred forty-seven patients with nasopharyngeal tumors (89 NPCs and 38 NPLs) who had undergone magnetic resonance imaging (MRI) and diffusion-weighted imaging were retrospectively analyzed. ADC histogram-derived parameters were compared between the NPC and NPL groups by using the Mann–Whitney U test. Receiver operating characteristic (ROC) curves of the histogram parameters were plotted for diagnostic accuracy. Sensitivity and specificity were calculated for each histogram parameter.

Results

In whole-tumor histogram analysis, the mean, median, and 10th and 25th percentiles of ADC were all significantly higher in NPC than NPL (P = 0.045, P = 0.035, P = 0.005, and P = 0.016, respectively). Uniformity was significantly higher in NPC than NPL (P = 0.001). Skewness was significantly lower in NPC than NPL (P = 0.039). For the conventional ROI-based method, ADCmean values were significantly higher in NPC than in NPL (P = 0.009). The ROC curve analysis showed that uniformity yielded the largest area under the curve (AUC = 0.768) for differentiating NPC from NPL among all ADC metrics, followed by 10th percentiles of ADC (AUC = 0.725); sensitivity and specificity were 76.5% and 71.4%, respectively.

Conclusion

Whole-tumor histogram analysis of ADC maps could be helpful for differentiating NPC from NPL.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

CI:

Confidence interval

DWI:

Diffusion-weighted imaging

NPC:

Nasopharyngeal carcinoma

NPL:

Nasopharyngeal lymphoma

ROC:

Receiver operating characteristic

ROI:

Regions of interest

VOI:

Volumes of interest

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Author notes

  1. Shanshan Lian and Cheng Zhang have equally contributed to this work.

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, ADD: 651 Dongfeng East Road, Guangzhou, 510060, People’s Republic of China

    Shanshan Lian, Cheng Zhang, Jun Chi, Yingyi Huang & Chuanmiao Xie

  2. Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China

    Shanshan Lian, Cheng Zhang, Yingyi Huang & Chuanmiao Xie

  3. Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China

    Jun Chi

  4. Department of Interventional Radiology, Guangdong Province People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Second Rd, Guangzhou, 510080, People’s Republic of China

    Feng Shi

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  1. Shanshan Lian
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  2. Cheng Zhang
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  3. Jun Chi
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Correspondence to Chuanmiao Xie.

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Lian, S., Zhang, C., Chi, J. et al. Differentiation between nasopharyngeal carcinoma and lymphoma at the primary site using whole-tumor histogram analysis of apparent diffusion coefficient maps. Radiol med 125, 647–653 (2020). https://doi.org/10.1007/s11547-020-01152-8

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  • DOI: https://doi.org/10.1007/s11547-020-01152-8

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