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Distinguishing early-stage nasopharyngeal carcinoma from benign hyperplasia using intravoxel incoherent motion diffusion-weighted MRI.
- Source :
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European radiology [Eur Radiol] 2019 Oct; Vol. 29 (10), pp. 5627-5634. Date of Electronic Publication: 2019 Mar 22. - Publication Year :
- 2019
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Abstract
- Objectives: MRI can detect early-stage nasopharyngeal carcinoma (NPC), but the detection is more challenging in early-stage NPCs because they must be distinguished from benign hyperplasia in the nasopharynx. This study aimed to determine whether intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) MRI could distinguish between these two entities.<br />Methods: Thirty-four subjects with early-stage NPC and 30 subjects with benign hyperplasia prospectively underwent IVIM DWI. The mean pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) values were calculated for all subjects and compared between the 2 groups using Student's t test. Receiver operating characteristics with the area under the curve (AUC) was used to identify the optimal threshold for all significant parameters, and the corresponding diagnostic performance was calculated. A p value of < 0.05 was considered statistically significant.<br />Results: Compared with benign hyperplasia, early-stage NPC exhibited a significantly lower D mean (0.64 ± 0.06 vs 0.87 ± 0.11 × 10 <superscript>-3</superscript>  mm <superscript>2</superscript> /s), ADC <subscript>0-1000</subscript> mean (0.77 ± 0.08 vs 1.00 ± 0.13 × 10 <superscript>-3</superscript>  mm <superscript>2</superscript> /s), ADC <subscript>300-1000</subscript> (0.63 ± 0.05 vs 0.86 ± 0.10 × 10 <superscript>-3</superscript>  mm <superscript>2</superscript> /s) and a higher D* mean (32.66 ± 4.79 vs 21.96 ± 5.21 × 10 <superscript>-3</superscript>  mm <superscript>2</superscript> /s) (all p < 0.001). No significant difference in the f mean was observed between the two groups (p = 0.216). The D and ADC <subscript>300-1000</subscript> mean had the highest AUC of 0.985 and 0.988, respectively, and the D mean of < 0.75 × 10 <superscript>-3</superscript>  mm <superscript>2</superscript> /s yielded the highest sensitivity, specificity and accuracy (100%, 93.3% and 96.9%, respectively) in distinguishing early-stage NPC from benign hyperplasia.<br />Conclusion: DWI has potential to distinguish early-stage NPC from benign hyperplasia and D and ADC <subscript>300-1000</subscript> mean were the most promising parameters.<br />Key Points: • Diffusion-weighted imaging has potential to distinguish early-stage nasopharyngeal carcinoma from benign hyperplasia in the nasopharynx. • The pure diffusion coefficient, pseudo-diffusion coefficient from intravoxel incoherent motion model and apparent diffusion coefficient from conventional diffusion-weighted imaging were significant parameters for distinguishing these two entities in the nasopharynx. • The pure diffusion coefficient, followed by apparent diffusion coefficient, may be the most promising parameters to be used in screening studies to help detect early-stage nasopharyngeal carcinoma.
- Subjects :
- Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Hyperplasia diagnosis
Male
Middle Aged
Nasopharyngeal Diseases diagnosis
ROC Curve
Reproducibility of Results
Diffusion Magnetic Resonance Imaging methods
Early Detection of Cancer methods
Nasopharyngeal Carcinoma diagnosis
Nasopharyngeal Neoplasms diagnosis
Neoplasm Staging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 29
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 30903340
- Full Text :
- https://doi.org/10.1007/s00330-019-06133-8