Ivestigation Of Correlation Between 3D PCASL And DCE-MRI On Nasopharyngeal Carcinoma

Objective: To investigate the application value of 3D pCASL and DCE-MRI imaging for nasopharyngeal carcinoma in different clinical stages,and to study the correlation between these two perfusion parameters.Material and Methods: Retrospective analysis was performed on 45 cases of nasopharyngeal carcinoma initially diagnosed pathologically in the Affiliated Anqing Hospital of Anhui Medical University from January 2017 to December 2018.All of the patients before treatment were performed MRI scan,3D pCASL and DCE-MRI scanning.According to the eighth edition of UICC/AJCC staging criteria,they were divided into high and low grade groups of clinical stage,T stage and N stage.The high-stage group includes 26 cases of clinical stage Ⅲ + Ⅳ,23 cases of T stage T3+T4 and 21 cases of N stage N2 + N3;The low-stage group includes 19 cases of clinical stageⅠ+Ⅱ,22 cases of T stage T1 + T2 and 24 cases of N stage N0 + N1.3D pCASL sets three groups of different delay time: PLD is 1525 ms,2025 ms and 2525 ms.The irregular ROI was used in the post-processing workstation to delineate the tumor boundary to obtain tumor blood flow.They were recorded as TBF(1.5),the TBF(2.0)and TBF(2.5).The pharmacokinetic parameters software was used to analyze the DCE-MRI images to obtain the parameters of Ktrans,Kep and Ve.The differences in 3D pCASL and DCE-MRI parameters between high and low stages of nasopharyngeal carcinoma were tested by independent-sample t test.Pearson correlation analysis was performed between TBF value and DCE parameter.Spearman correlation analysis was used to analyze the correlation between TBF value and DCE parameters.While the diagnostic efficacy in high and low stages of nasopharyngeal carcinoma was analyzed by ROC curve.Result: There were statistically significances in TBF(1.5),TBF(2.0),TBF(2.5),Ktrans and Kep among the clinical stage,T stage and N stage of nasopharyngeal carcinoma(P<0.05),while the Ve value was not significant.TBF(1.5),TBF(2.0),TBF(2.5),Ktrans and Kep had good correlation with different clinical stages,T stages and N stages of nasopharyngeal carcinoma(r=0.462-0.716,P≤0.001),of which TBF(2.0)had the best correlation(0.686,0.613,0.710 respectively),while Ve had no significant correlation with nasopharyngeal carcinoma.TBF(1.5),TBF(2.0),TBF(2.5)were significantly positively correlated with Ktrans and Kep.TBF(2.0)had the best correlation(the correlation coefficients with Ktrans and Kep were 0.799 and 0.548,P=0.000,respectively),and had no correlation with Ve.TBF(1.5),TBF(2.0),TBF(2.5),Ktrans and Kep had good diagnostic efficacy for high and low stages of nasopharyngeal carcinoma.Ktrans had the best diagnostic efficacy(AUC=0.918,sensitivity = 0.846,specificity = 0.789),followed by TBF(2.0)(AUC= 0.901,sensitivity = 0.808,specificity = 0.842),thus Ktrans is slightly better than TBF(2.0).Conclusion: Both 3D pCASL and DCE-MRI can well reflect the perfusion signal of nasopharyngeal carcinoma tumors,which are used to predict different clinical stages of nasopharyngeal carcinoma.There is significant consistency between them.When PLD was set to 2025 ms,the correlation with DEC-MRI parameters was the best.3D pCASL is an another effective alternative method for noninvasive evaluation of nasopharyngeal carcinoma perfusion level.