| Diagnostic efficiency of pathological differentiation with 18F-FDG PET/MR in head and neck squamous cell carcinomaObjective:To evaluate diagnostic efficiency of tumor differentiation in head and neck squamous cell carcinoma(HNSCC)with multi-parameters of positron emission tomography/magnetic resonance imaging(PET/MR)independently and combined.Materials and Methods Patients with clinical suspicion or diagnosis by biopsy of tumors in head and neck were included and had undergone PET/MR examination with multi-parameters.The PET/MR examination included 18 fluorine-fluorodeoxyglucose(18F-FDG)PET and MR sequences of T2 weighted imaging,T1 weighted imaging,diffusion weighted imaging(DWI),apparent diffusion coefficient(ADC)and dynamic contrast enhancement(DCE).The multi-parameters of PET/MR included the mean value of ADC(ADCmean),the quantitative parameters of DCE(Ktrans:Transport constant;Ve Extracellular space volume percentage,Kep:Rate constant),and the mean value and maximum value of standardized uptake value(SUVmean,SUVmax).According to postoperative pathology,patients with HNSCC were included,the tumor differentiations were obtained subsequently.The correlations between the parameters of PET/MR were analyzed with Spearman analysis.The distributions of all PET/MR parameters were tested by the test of normal distribution,and the statistical differences in the distribution of PET/MR parameters between the groups of tumor differentiation were analyzed with nonparametric test of Mann-Whitney U,subsequently.Logistic regression was utilized to establish the predictive model of tumor differentiation with PET/MR parameters.The efficacies of the independent and combined parameters with PET/MR for the diagnosis of tumor differentiation in HNSCC were analyzed according to the ROC curve.The P value less than 0.05 was considered statistically significant.Results(1)The study finally included 23 patients with 9 cases of well differentiation and 14 cases of moderate-poor differentiation(10 cases of moderate differentiation and 4 cases of poor differentiation).(2)There was statistical correlations between Ve with SUVmean(P=0.05),Ve with ADCmean(P=0.04),and SUVmean with SUVmax(P<0.001)While no statistical correlations(P= 0.09-0.77)between other groups.(3)The statistical differences between different groups of tumor differentiation were obviously in ADCmean and SUVmean with P values of 0.012 and 0.016,while no significant differences with other parameters.(4)Combination of PET/MR had better predictive efficacy of tumor differentiation with area under the curve of 0.87,compared with the independent parameters.Conclusion PET/MR can be integrated to obtain multiple parameters with DWI?DCE and PET.Compared to the independent parameters,the combination of PET/MR can improve the diagnostic performance in tumor differentiation of HNSCC.Diagnostic value of cervical lymph node metastasis with 18F-FDG PET/MR in head and neck squamous cell carcinomaObjective:To evaluate the diagnostic value of cervical lymph node metastasis in head and neck squamous cell carcinoma(HNSCC)with multi-parameters of positron emission tomography/magnetic resonance imaging(PET/MR)both in independence and combination.Material and Methods:The preoperative PET/MR examinations were underwent in 18 patients who were diagnosed with HNSCC and planned for primary resection and lymph node dissection.The PET/MR sequences included T1 weighted imaging,T2 weighted imaging,diffusion weighted imaging(DWI),apparent diffusion coefficient(ADC),dynamic contrast enmancement(DCE)and i8 Fluorine-Fluorodeoxyglucose(18F-FDG)PET.The parameters included the mean value of ADC(ADCmean),the quantitative parameters of DCE(Ktrans:transport constant;Ve extracellular space volume percentage,Kep:rate constant),and the mean value and maximum value of standardized uptake value(SUVmean,SUVmax).The PET/MR parameters of lymph nodes in neck region with the maximum diameter larger than 10mm were measured.The final diagnosis of cervical lymph nodes were obtained with pathological diagnosis according to localization before and during operation.The correlations of the parameters of PET/MR were analyzed with Spearman analysis.The distributions of all the parameters were tested by the test of normal distribution,and the differences in the distribution of PET/MR parameters between the groups of lymph node metastasis and no metastasis were tested by the statistical method.The Logistic regression analysis was used to establish the predictive model of lymph node metastasis with PET/MR combined parameters.The efficacies of the independent and combined parameters with PET/MR for the diagnosis of HNSCC lymph node metastasis were calculated according to the ROC curve analysis.The P value less than or equal to 0.05 was considered statistically significant.Results:The study finally included 16 patients with 12 males and 4 females.The average age were 62.0 ±9.1 and 61.0±6.8 years old in the groups of lymph node metastasis and no metastasis.The study included 9 patients diagnosed with lymph node metastasis and 7 patients diagnosed with no metastasis.There were 95 lymph nodes in the study including 30 metastatic lymph nodes and 65 benign lymph nodes with pathological diagnosis.(2)There were statistical correlations between PET/MR parameters of SUVmean with SUVmax and Ve,SUVmax with Ve,Ktrans with Ve and Kep,with P values less than 0.05.(3)There were statistical differences between the groups of lymph node metastasis and the non metastasis with the paremeters of SUVmax,SUVmean,Ktrans and Ve,with P values less than 0.05.(4)Compared with PET/MR independent parameters,the efficacy of diagnosis in lymph node metastasis with PET/MR combined parameter was the best with the area under the ROC curve of 0.91(P<0.001).Conclusion:Compared to the independent parameters of DWI,DCE and PET with PET/MR,the combined parameter was more efficacious for the preoperative diagnosis of cervical lymph node metastasis in HNSCC.Correlation between 18F-FDG PET/MR parameters with the expression level of epidermal growth factor receptor and the predictive value with PET/MR in head and neck squamous cell carcinomaObjective:To investigate the correlation between the parameters of positron emission tomography/magnetic resonance imaging(PET/MR)and the expression level of epidermal growth factor receptor(EGFR)in head and neck squamous cell carcinoma(HNSCC)and to evaluate predictive value of the expression level of EGFR with independent and combined parameters of PET/MR.Materials and Methods:The retrospective study included 21 patients who had undergone cervical PET/MR and with the postoperative pathological diagnosis of HNSCC.PET/MR sequences included 18 Fluorodeoxyglucose(18F-FDG)PET and T1 weighted imaging,T2 weighted imaging,diffusion weighted imaging(DWI),apparent diffusion coefficient(ADC)and dynamic contrast enhancement(DCE).The multi parameters of PET/MR included the mean value of ADC(ADCmean)and the quantitative parameters of DCE(Ktrans:transport constant;Ve extracellular space volume percentage,Kep:rate constant),the mean value and maximum value of standardized uptake value(SUVmean,SUVmax).Immuno-histochemistry was used to detect the expression level of EGFR in all patients.The correlations between the expression level of EGFR and the parameters of PET/MR were measured with Spearman analysis.The distribution of PET/MR parameters was tested for normal distribution,and the differences of distribution between two groups of expression levels in EGFR was tested with nonparametric test of Mann-Whitney U subsequently.Logistic regression was utilized to establish the predictive model of expression levels in EGFR with PET/MR parameters.The efficacies of the independent and combined predictive model of PET/MR parameters for the diagnosis of expression levels of EGFR in HNSCC were analyzed according to the ROC curve.The P value less than or equal to 0.05 was considered statistically significant.Results:(1)The positive expression rate of EGFR was 95.23%(20/21)in all the included 21 patients.There were 9 cases with high level of EGFR expression and 12 cases with low level of EGFR expression.(2)The expression level of EGFR was statistically correlated to SUVmean with the correlation coefficient of 0.47 and P value of 0.05.(3)There was a significant difference between the EGFR high expression group and the low expression group with SUVmean,the P value was 0.02.(4)According to the ROC curve analysis,the combination of PET/MR improved the predictive efficiency of the expression level of EGFR with the area under the curve of 0.93.Conclusion:There were differently statistical correlations between the parameters of PET/MR and the level of EGFR expression in HNSCC.The combination of PET/MR can improve the predictive efficiency in the expression level of EGFR. |
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