Quantitative parameters correlated well with differentiation of squamous cell carcinoma at head and neck: a study of dynamic contrast-enhanced MRI

Abstract

Background

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is widely used for the diagnosis and prognostic assessment of head and neck squamous cell carcinoma (HNSCC). However, no research on grading HNSCC using DCE-MRI has been found. We hypothesize that DCE-MRI can grade the HNSCC non-invasively.

Purpose

To verify the hypothesis that DCE-MRI can grade the HNSCC non-invasively.

Material and Methods

Forty-two patients with histopathologically proved HNSCC from September 2013 to February 2016 were retrospectively analyzed. Chi-square test was used to compare patterns of time intensity curves (TICs) between well and poorly differentiated HNSCC. Two-sample t-test was performed to calculate the difference of volume transfer constant (K_trans), extravascular extracellular volume fraction (V_e), and initial area under the curve (iAUC) between groups. The diagnostic ability and cut-off value were assessed by receiver operator characteristic analysis.

Results

Most TICs of HNSCC are type III; no difference between well and poorly differentiated HNSCC has been found (P > 0.05). The value of K_trans, V_e, and iAUC for well and poorly differentiated HNSCC are (0.218 ± 0.048; 0.383 ± 0.074) min⁻¹, (0.605 ± 0.108; 0.712 ± 0.150), and (27.552 ± 6.238; 43.157 ± 9.148), respectively. K_trans, V_e, and iAUC are higher in poorly differentiated HNSCC, compared with well differentiated HNSCC (P < 0.001, 0.013, and < 0.001, respectively). K_trans has the greatest diagnostic significance with Youden’s index being 0.859 by cut-off value 0.270 min⁻¹. The diagnostic sensitivity and specificity were 95.0% and 90.9%, respectively.

Conclusion

The K_trans, V_e, and iAUC of HNSCC can be reliable quantitative parameters for evaluating well and poorly differentiated HNSCC where K_trans has the highest value.