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Standard diffusion-weighted, diffusion kurtosis and intravoxel incoherent motion MR imaging of sinonasal malignancies: correlations with Ki-67 proliferation status

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Abstract

Objectives

To explore the correlations of parameters derived from standard diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) with the Ki-67 proliferation status.

Methods

Seventy-five patients with histologically proven sinonasal malignancies who underwent standard DWI, DKI and IVIM were retrospectively reviewed. The mean, minimum, maximum and whole standard DWI [apparent diffusion coefficient (ADC)], DKI [diffusion kurtosis (K) and diffusion coefficient (Dk)] and IVIM [pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f)] parameters were measured and correlated with the Ki-67 labelling index (LI). The Ki-67 LI was categorised as high (> 50%) or low (≤ 50%).

Results

The K and f values were positively correlated with the Ki-67 LI (rho = 0.295~0.532), whereas the ADC, Dk and D values were negatively correlated with the Ki-67 LI (rho = -0.443~-0.277). The ADC, Dk and D values were lower, whereas the K value was higher in sinonasal malignancies with a high Ki-67 LI than in those in a low Ki-67 LI (all p < 0.05). A higher maximum K value (Kmax > 0.977) independently predicted a high Ki-67 status [odds ratio (OR) = 7.614; 95% confidence interval (CI) = 2.197-38.674; p = 0.017].

Conclusion

ADC, Dk, K, D and f are correlated with Ki-67 LI. Kmax is the strongest independent factor for predicting Ki-67 status.

Key Points

• DWI-derived parameters from different models are capable of providing different pathophysiological information.

• DWI, DKI and IVIM parameters are associated with Ki-67 proliferation status.

• K max derived from DKI is the strongest independent factor for the prediction of Ki-67 proliferation status.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

CI:

Confidence interval

DKI:

Diffusion kurtosis imaging

DWI:

Diffusion-weighted imaging

EPI:

Echo planar imaging

FOV:

Field of view

ICC:

Intraclass correlation coefficient

IVIM:

Intravoxel incoherent motion

LI:

Labelling index

NPV:

Negative predictive value

OR:

Odds ratio

PPV:

Positive predictive value

ROC:

Receiver-operating characteristic

ROIs:

Regions of interest

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Funding

This study has received funding from the Grant of Science and Technology Commission of Shanghai Municipality (no. 17411962100; 14411962000) and Shanghai Municipal Commission of Health and Family Planning (grant no. ZK2015A05).

Author information

Author notes

  1. Zebin Xiao and Yufeng Zhong contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People’s Republic of China

    Zebin Xiao, Yufeng Zhong, Zuohua Tang, Wen Qian & Rong Wang

  2. Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, 1508 Longhang Road, Shanghai, 201508, People’s Republic of China

    Yufeng Zhong & Jinwei Qiang

  3. Department of Radiotherapy, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, 200031, China

    Jie Wang

  4. Department of Otolaryngology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, 200031, China

    Lingjie Wu

  5. Siemens Healthcare Ltd., Shanghai, 201318, People’s Republic of China

    Wenlin Tang & Zhongshuai Zhang

Authors
  1. Zebin Xiao
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  2. Yufeng Zhong
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  3. Zuohua Tang
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  4. Jinwei Qiang
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  5. Wen Qian
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  7. Jie Wang
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  9. Wenlin Tang
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Corresponding authors

Correspondence to Zuohua Tang or Jinwei Qiang.

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Guarantor

The scientific guarantor of this publication is Prof. Zuohua Tang, MD, PhD, Eye and ENT Hospital of Shanghai Medical School, Fudan University, and Prof. Jinwei Qiang, MD, PhD, Jinshan Hospital of Shanghai Medical School, Fudan University.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Xiao, Z., Zhong, Y., Tang, Z. et al. Standard diffusion-weighted, diffusion kurtosis and intravoxel incoherent motion MR imaging of sinonasal malignancies: correlations with Ki-67 proliferation status. Eur Radiol 28, 2923–2933 (2018). https://doi.org/10.1007/s00330-017-5286-x

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  • DOI: https://doi.org/10.1007/s00330-017-5286-x

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