Whole-lesion ADC histogram analysis is not able to reflect microvessel density in HNSCC

Diffusion-weighted imaging (DWI) is a functional imaging technique sensitive to microstructure in tissues. It is widely acknowledged to reflect cellularity in tumors. A small part of DWI is also sensitive to perfusion-related information and might therefore be also be able to reflect microvessel density in tumor tissues. Aim of the present study was to elucidate possible correlations between microvessel density and apparent diffusion coefficient (ADC) values in head and neck squamous cell carcinoma (HNSCC).Thirty-four patients with histologically proven primary HNSCC were included in the study. DWI was performed with a 3 T magnetic resonance imaging (MRI) (b-values 0 and 800 s/mm) and histogram analysis was calculated with a whole lesion measurement. In every case, microvessel density was estimated with CD105-stained specimens.There were no statistically significant correlations between ADC histogram parameters and microvessel density. The calculated correlation coefficients ranged from r = -0.27, P = .13 for entropy and vessel area to r = 0.16, P = .40 for ADCmin and vessel count.Whole-lesion histogram analysis of ADC values cannot reflect microvessel density in HNSCC.

ADC-histogram analysis in head and neck squamous cell carcinoma. Associations with different histopathological features including expression of EGFR, VEGF, HIF-1α, Her 2 and p53. A preliminary study

OBJECTIVE

Apparent diffusion coefficient (ADC) values derived from Diffusion-weighted images are able to reflect tumor microstructure, such as cellularity, extracellular matrix or proliferation potential. This present study sought to correlate prognostic relevant histopathologic parameters with ADC values derived from a whole lesion measurement in head and neck squamous cell carcinoma (HNSCC).

MATERIALS AND METHODS

Thirty-four patients with histological proven primary HNSCC were prospectively acquired. Histogram analysis was derived from ADC maps. In all cases, expression of Hif1-alpha, VEGF, EGFR, p53, p16, Her 2 were analyzed.

RESULTS

In the overall patient sample, ADCmax correlated with p53 expression (p = -0.446, p = 0.009) and ADCmode correlated with Her2-expression (p = -0.354, p = 0.047). In the p16 positive group there were several correlations. P25, P90 and entropy correlated with Hif1-alpha (p = -0.423, p = 0.05, p = -0.494, p = 0.019, p = 0.479, p = 0.024, respectively). Kurtosis correlated with P53 expression (p = -0.466, p = 0.029). For p16 negative carcinomas the following associations could be identified. Mode correlated with VEGF-expression (p = -0.657, p = 0.039). ADCmax, P75, P90, and Std correlated with p53-expression (p = -0.827, p = 0.002, p = -0.736, p = 0.01, p = -0.836, p = 0.001 and p = -0.70, p = 0.016, respectively). There were no statistically significant differences of ADC histogram parameters between p16 positive and p16 negative carcinomas.

CONCLUSION

ADC histogram values can reflect different histopathological features in HNSCC. Associations between ADC histogram analysis parameters and histopathology depend on p16 status.

Histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging can predict histopathological findings including proliferation potential, cellularity, and nucleic areas in head and neck squamous cell carcinoma

Our purpose was to analyze possible associations between histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging DCE MRI and histopathological findings like proliferation index, cell count and nucleic areas in head and neck squamous cell carcinoma (HNSCC).

30 patients (mean age 57.0 years) with primary HNSCC were included in the study. In every case, histogram analysis parameters of K_trans, V_e, and K_ep were estimated using a mathlab based software. Tumor proliferation index, cell count, and nucleic areas were estimated on Ki 67 antigen stained specimens. Spearman's non-parametric rank sum correlation coefficients were calculated between DCE and different histopathological parameters.

KI 67 correlated with K_trans min (p = −0.386, P = 0.043) and s K_trans skewness (p = 0.382, P = 0.045), V_e min (p = −0.473, P = 0.011), Ve entropy (p = 0.424, P = 0.025), and K_ep entropy (p = 0.464, P = 0.013). Cell count correlated with K_trans kurtosis (p = 0.40, P = 0.034), V_e entropy (p = 0.475, P = 0.011). Total nucleic area correlated with V_e max (p = 0.386, P = 0.042) and V_e entropy (p = 0.411, P = 0.030).

In G1/2 tumors, only K_trans entropy correlated well with total (P =0.78, P =0.013) and average nucleic areas (p = 0.655, P = 0.006). In G3 tumors, KI 67 correlated with Ve min (p = −0.552, P = 0.022) and V_e entropy (p = 0.524, P = 0.031). Ve max correlated with total nucleic area (p = 0.483, P = 0.049). Kep max correlated with total area (p = −0.51, P = 0.037), and K_ep entropy with KI 67 (p = 0.567, P = 0.018).

We concluded that histogram-based parameters skewness, kurtosis and entropy of K_trans, V_e, and K_ep can be used as markers for proliferation activity, cellularity and nucleic content in HNSCC. Tumor grading influences significantly associations between perfusion and histopathological parameters.

Associations Between Histogram Analysis DCE MRI Parameters and Complex 18F-FDG-PET Values in Head and Neck Squamous Cell Carcinoma

AIM

To analyze associations between parameters of positron-emission tomography (PET) and histogram analysis values of dynamic contrast-enhanced (DCE) imaging in patients with head and neck squamous cell carcinoma (HNSCC).

PATIENTS AND METHODS

Overall, 28 patients with primary HNSCC of different localizations were involved. ¹⁸F-FDG-PET/CT and DCE MR imaging were performed for all patients. Histogram analysis parameters of DCE MRI were calculated. Spearman's correlation coefficient was used to analyze the associations between investigated parameters.

RESULTS

In the overall cohort, SUV_max correlated with K_ep P10 (ρ=0.43, p=0.027), K_ep P25 (0.40, p=0.035), and had a tendency to correlate with median K_ep (ρ=0.33, p=0.098). TLG tended to correlate with K_ep P25 (0.33, p=0.09) and P10 K_trans (ρ=0.35, p=0.07). In G1/2 tumors, SUV_max correlated with K_ep P10 (ρ=0.645, p=0.032), and tended to correlate with K_trans mean (ρ=0.54, p=0.089), K_trans min (ρ=0.58, p=0.06), K_trans P10 (ρ=0.56, p=0.07), K_trans P25 (ρ=0.59, p=0.056), and K_trans median (ρ=0.054, p=0.089), as well with K_ep min (ρ=0.56, p=0.07). SUVmean tended to correlate with K_ep kurtosis (ρ=0.56, p=0.07). In G3 tumors, no tendencies or statistically significant correlations between the PET and DCE MRI parameters were identified.

CONCLUSION

Tumor metabolism and perfusion show complex associations in HNSCC. These associations depend on tumor grading.

Secondary hypertrophic osteoarthropathy caused by non-pleural or pulmonary tumors

Hypertrophic osteoarthropathy (HOA) is a rare paraneoplastic syndrome characterized by digital clubbing, periosteal reaction, polyarthralgia, arthritis, and synovitis. Herein, we report a case series of patients with secondary HOA caused by non-pleural or pulmonary tumors.The radiologic databases of 2 tertiary university hospitals were retrospectively screened for secondary HOA patients. In addition, a systemic review of the published case reports. Only HOA cases with non-pleural or pulmonary malignancies were involved into the study. HOA in primary pleural or pulmonary malignant or benign disorders, as well in inflammatory diseases were excluded. In all cases, plain radiography was performed and clinical signs were documented.In our databases, 6 patients with secondary HOA were identified. In addition, the systemic review yielded 24 eligible patients. The most prevalent primary tumors were nasopharyngeal carcinoma and esophageal cancer in 6 patients (20%), respectively. In 17 patients, (56.7%) HOA was associated with lung metastases, and in 10 patients (33.3%), no lung metastases were detected. In 14 patients (46.7%), HOA was symptomatically before a tumor diagnosis was made. Plain radiography displayed typically features with periostal enlargement in every case.This study is the first report about secondary HOA caused by non-pleural or pulmonary tumors. Various primary tumors were identified, including several rare tumors such as sarcomas. HOA is a rare disorder with typically radiologically findings, which is not only associated with lung cancer or pleural mesothelioma and can even occur in tumor patients without lung metastasis.