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Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value

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Abstract

A perfusion defect (PD) in non-enlarged lymph nodes (LNs) of oral squamous cell carcinoma (OSCC) is the most reliable radiological criterion for the diagnosis of metastasis. However, conventional contrast-enhanced (CE) T1 weighted images using turbo spin echo (TSE) sequence is limited in detecting PD in non-enlarged LNs due to flow artifacts from cervical blood vessels. Vessel wall (VW) MR imaging with blood vessel flow suppression and high spatial resolution may provide new insights into the detection of PD. However, there are no reports in the literature on the usefulness of VW MR imaging for the diagnosis of LN metastasis. It is demonstrated that PD of non-enlarged LNs in CE VR MR imaging of OSCC patients is useful for the diagnosis of metastatic LNs. VW MR imaging was significantly more sensitive in detecting PD of non-enlarged metastatic LNs than conventional TSE imaging on visual evaluation. Furthermore, it was found that the image contrast between PD and surrounding intranodal tissue in CE VW MR images was higher than that in conventional CE TSE images. In the correlation between imaging and histopathological findings of metastatic LNs, all LNs that exhibited PD on CE VW MR images were at an advanced histopathological metastatic stage. The pathology of PD was necrotic tissue with keratinization. The results indicated that PD in CE VW imaging is useful in diagnosing non-enlarged LNs at an advanced metastasis stage. The addition of VW MR imaging to conventional MR examination achieves higher diagnostic performance for non-enlarged metastatic LNs.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

PD:

Perfusion defect

LN:

Lymph node

OSCC:

Oral squamous cell carcinoma

MR:

Magnetic resonance

TSE:

Turbo spin echo

CE:

Contrast enhanced

VW:

Vessel wall

MSDE-VISTA:

Motion-sensitized driven equilibrium-volume isotropic turbo spin echo acquisition

CT:

Computed tomography

2D:

Two-dimensional

3D:

Three-dimensional

T1W:

T1-weighted

T2W:

T2-weighted

SNR:

Signal-to-noise ratio

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Acknowledgments

This study was supported in part by JSPS KAKENHI Grants 18H03544 (M.S.), 20H00655 (T.K.), and 21K18319(T.K.). We thank Hideki Ota, Tatsuo Nagasaka, and Ariunbuyan Sukhbaatar for their excellent technical support. In addition, we thank  Mika Watanabe for her histopathological support.

Author information

Authors and Affiliations

  1. Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan

    Maya Sakamoto, Shiro Mori & Tetsuya Kodama

  2. Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan

    Maya Sakamoto, Shiro Mori & Tetsuya Kodama

  3. Department of Dental Informatics and Radiology, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan

    Maya Sakamoto, Ikuho Kojima & Masahiro Iikubo

  4. Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan

    Ikuho Kojima, Masahiro Iikubo & Yukio Katori

  5. Department of Computer and Mathematical Sciences, Graduate School of Information Sciences, Tohoku University, Aramaki Aza, Aoba, Sendai, Miyagi, 980-8579, Japan

    Koichi Ito & Takafumi Aoki

  6. Department of Oral and Maxillofacial Surgery, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan

    Shiro Mori

  7. Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan

    Takenori Ogawa & Yukio Katori

  8. Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan

    Takenori Ogawa

  9. Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan

    Takaki Murata

  10. Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan

    Daisuke Ito

Authors
  1. Maya Sakamoto
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  11. Tetsuya Kodama
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Contributions

SM interpreted all of the data and supervised the project. KI and IM performed the imaging analyses and statistical analysis. IK and AT analyzed the imaging data using a developed proprietary volume registration method. OT, KY and MS performed neck dissection and the pathological analysis. ID and MT designed the new magnetic resonance imaging methodologies and interpreted the imaging data. KT interpreted all of the data and supervised the project.

Corresponding author

Correspondence to Maya Sakamoto.

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Sakamoto, M., Kojima, I., Iikubo, M. et al. Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value. Clin Exp Metastasis 39, 421–431 (2022). https://doi.org/10.1007/s10585-022-10147-w

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