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Histogram analysis of diffusion-weighted imaging and dynamic contrast-enhanced MRI for predicting occult lymph node metastasis in early-stage oral tongue squamous cell carcinoma

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Abstract

Objectives

To investigate the feasibility of whole-tumor histogram analysis of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI for predicting occult lymph node metastasis (LNM) in early-stage oral tongue squamous cell cancer (OTSCC).

Materials and methods

This retrospective study included 55 early-stage OTSCC (cT1-2N0M0) patients; 34 with pathological LNM and 21 without. Eight whole-tumor histogram features were extracted from quantitative apparent diffusion coefficient (ADC) maps and two semi-quantitative DCE parametric maps (wash-in and wash-out). The clinicopathological factors and histogram features were compared between the two groups. Stepwise logistic regression was used to identify independent predictors. Receiver operating characteristic curves were generated to assess the performances of significant variables and a combined model for predicting occult LNM.

Results

MRI-determined depth of invasion and ADCentropy was significantly higher in the LNM group, with respective areas under the curve (AUCs) of 0.67 and 0.69, and accuracies of 0.73 and 0.73. ADC10th. ADCuniformity and wash-inskewness were significantly lower in the LNM group, with respective AUCs of 0.68, 0.71, and 0.69, and accuracies of 0.65, 0.71, and 0.64. Histogram features from wash-out maps were not significantly associated with cervical node status. In the logistic regression analysis, ADC10th, ADCuniformity, and wash-inskewness were independent predictors. The combined model yielded the best predictive performance, with an AUC of 0.87 and an accuracy of 0.82.

Conclusions

Whole-tumor histogram analysis of ADC and wash-in maps is a feasible tool for preoperative evaluation of cervical node status in early-stage OTSCC.

Key Points

• Histogram analysis of parametric maps from DWI and DCE-MRI may assist the prediction of occult LNM in early-stage OTSCC.

• ADC 10th , ADC uniformity , and wash-in skewness were independent predictors.

• The combined model exhibited good predictive performance, with an accuracy of 0.82.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

DCE:

Dynamic contrast-enhanced

DOI:

Depth of invasion

DWI:

Diffusion-weighted imaging

ICC:

Intraclass correlation coefficient

LNM:

Lymph node metastasis

MRI:

Magnetic resonance imaging

OTSCC:

Oral tongue squamous cell carcinoma

ROC:

Receiver operating characteristic

ROI:

Region of interest

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Funding

This work was supported by funds from the National Scientific Foundation of China (91859202, 81771901) and the Shanghai Municipal Health Commission (20194Y0104).

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Author notes

  1. Jiliang Ren and Ying Yuan contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200010, China

    Jiliang Ren, Ying Yuan & Xiaofeng Tao

Authors
  1. Jiliang Ren
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  2. Ying Yuan
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  3. Xiaofeng Tao
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Correspondence to Xiaofeng Tao.

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The scientific guarantor of this publication is Prof. Xiaofeng Tao.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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Ren, J., Yuan, Y. & Tao, X. Histogram analysis of diffusion-weighted imaging and dynamic contrast-enhanced MRI for predicting occult lymph node metastasis in early-stage oral tongue squamous cell carcinoma. Eur Radiol 32, 2739–2747 (2022). https://doi.org/10.1007/s00330-021-08310-0

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