| Part Ⅰ Relationship between histogram analysis of traditional DWI,intravoxel incoherent motion DWI quantitative parameters and nasopharyngeal carcinoma clinical stageObjective: To investigate the potential roleofthe histogram analysisoftraditional DWI,IVIM-DWI for clinical stage of nasopharyngealcancer(NPC).Materials and Methods:Seventy newly diagnosed NPC patients(56non-cornification carcinomas and 14 diversification carcinomas)who underwent nasopharyngeal and neck MRI(including IVIM-DWI sequence)were enrolled.All cases were staged according to the eighth edition of NPC clinical stagingof AJCC /UICC.The histogram analysis of traditional DWI,IVIM-DWIwereperformed by using voxel-based analysis for the whole lesion volume.The traditional DWIquantitative parameter was ADC,IVIM-DWI quantitative parameters included D,f and D*.The histogram parameters ofeach IVIM-DWIquantitative parameters and ADCincluded mean,median,10 th,25th,75 th,90th,skewness and kurtosis.Spearman correlation was used to characterize the association between the traditional DWI,IVIM-DWI histogram quantitative parameters and NPC clinical stage(T staging,N staging,M staging and total clinical staging).Results: The histogram-based ADC(mean,75 th,90th),D(mean,median,75 th,90th,skewness,kurtosis)and D*(mean,90th)had a correlation with T staging(Spearman coefficient =-0.381、-0.334、-0.576、-0.572、-0.601、-0.630、-0.806、0.390、0.302 and 0.476、0.514 respectively,P<0.05).The histogram-based ADC(mean),D(mean,median,kurtosis)and D*(mean)had a correlation with N staging(Spearman coefficient =-0.479、-0.803、-0.428、0.574 and 0.317 respectively,P<0.05).The histogram-based D mean value showed negative correlation with the M stage(Spearman=-0.402,P < 0.05).The histogram-based ADC(mean,75 th,90th),D(mean,median,75 th,90th,skewness,kurtosis)and D*(mean,90th)had a correlation with total clinical staging(Spearman coefficient =-0.411、-0.286、-0.518、-0.766、-0.808、-0.617、-0.613、0.677、0.671 and 0.410、0.363 respectively,P<0.05).The histogram-based f had no correlation with NPC clinical stage(T staging,N staging,M staging and total clinical staging).The histogram-based ADC had no correlation with M staging.The histogram-based ADC(90th)from I to IV stage showed a trend of decrease and the difference was statistically significant(X2=24.006,P<0.05).Furtherly,differences between II and III stage,II and IVstage were statistically significant(P=0.003、0.000,respectively).The histogram-based D(median value)from I to IV stage showed a trend of decrease and the difference was statistically significant(X2=21.755,P<0.05).Furtherly,differences during the different total clinicalstages were statistically significant(P<0.05).The histogram-based D*(mean value)from I to IVstage showed a trend of increase,and the difference was statistically significant(X2=15.923,P<0.05).Furtherly,differences between II and III stage,II and IV stage were statistically significant(P=0.007、0.004,respectively).Conclusion: The histogram analysis of traditional DWI,IVIM-DWI quantitative parametersshowed that the multiple parameters associated with NPC clinical stage and some parameters of D had obviously advantage.So IVIM-DWI quantitative parameters couldmore accurately reflect the internal characteristics of tumor tissue thantraditional DWI and may play a role in clinical stage of NPC.Part Ⅱ Relationship between histogram analysis of dynamic contranst enhanced MRI quantitative parameters and nasopharyngeal carcinoma clinical stageObjective: To investigate the potential role ofthe histogram analysis of DCE-MRI for clinical stage of nasopharyngealcancer(NPC)Materials and Methods:Seventy newly diagnosed NPC patients(56non-cornification carcinomas and 14 diversification carcinomas)who underwent nasopharyngeal and neck MRI(including DCE-MRI sequence)were enrolled.All cases were staged according to the eighth edition of NPC clinical staging of AJCC /UICC.The histogram analysisof DCE-MRIwas performed by using voxel-based analysis for the whole lesion volume.DCE-MRI quantitative parameters included Ktrans,Kep and Ve.The histogram parameters of each DCE-MRI quantitative parameters included mean,median,10 th,25th,75 th,90th,skewness and kurtosis.Spearman correlation was used to characterize the association between the DCE-MRI histogram quantitative parameters and NPC clinical stage(T staging,N staging,M staging and total clinical staging).Results: The histogram-based Ktrans(mean,10 th,75th,90th),Kep(mean,10 th,kurtosis)and Ve(mean,90 th,skewness)had a correlation with T staging(Spearman coefficient = 0.770、0.519、0.787、0.350、-0.253、0.611、-0.384、0.660、0.654、-0.241 respectively,P<0.05).The histogram-based Ktrans(mean)and Ve(mean,90th)had a correlation with N staging(Spearman coefficient =0.306、0.810、0.780 respectively,P<0.05).The histogram-based Kep(kurtosis)and Ve(mean)had a correlation with M staging(Spearman coefficient =-0.243、0.262 respectively,P<0.05).The histogram-based Kep had no correlation with N staging,Ktrans had no correlation with M staging.The histogram-based Ktrans(mean,10 th,75th,90th),Kep(10th,75 th,kurtosis)and Ve(mean,75 th,90th)had a correlation with total clinical staging(Spearman coefficient = 0.593、0.336、0.560、0.263、0.422、-0.324、-0.295、0.897、0.289、0.901 respectively,P<0.05).The histogram-based Ktrans(mean),Kep(10th)and Ve(90th)during the total clinical staging had statistical significance(X2=30.440、26.066、56.350 respectively,P<0.05).The histogram-based Ktransfrom I to IV stage gradually increase.Furtherly,differences between II and III stage,II and IV stage were statistically significant(P=0.006 、 0.000,respectively).Thedifferences between I and II stage,III and IVstage,II and IVstageof the histogram-based Kep 10 th were statistically significant(P=0.031 、 0.001 、 0.000,respectively).The histogram-based Ve 90 th from I to IVstage gradually increase.Furtherly,differences between II and IV stage,III and IV stage were statistically significant(P=0.000、0.000,respectively).Conclusion: The histogram analysis of DCE-MRI quantitative parameters showed that the multiple parameters associated with NPC clinical stage.So DCE-MRI quantitative parameters could reflect the internal perfusion characteristics of tumor tissue,the invasive of NPC and associate with the progression of NPC.The histogram analysis of DCE-MRI quantitative parameters may play a role in clinical stage of NPC. |
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