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Relationships between apparent diffusion coefficient (ADC) histogram analysis parameters and PD-L 1-expression in
Hans-Jonas Meyer1, Anne Kathrin Höhn2, Alexey Surov3
1Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
Radiology and Oncology
|March 25, 2021
Summary
Diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values showed a weak association with programmed cell death ligand 1 (PD-L1) expression in head and neck squamous cell cancer (HNSCC). This imaging method may not reliably predict PD-L1 levels for immunotherapy selection in HNSCC patients.
Area of Science:
- Oncology
- Radiology
- Immunology
Background:
- Immunotherapy is a key cancer treatment, necessitating non-invasive expression prediction methods.
- Programmed cell death ligand 1 (PD-L1) expression is a crucial biomarker for immunotherapy response.
- Head and neck squamous cell cancer (HNSCC) treatment can be guided by immunotherapy biomarkers.
Purpose of the Study:
- To investigate the association between diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) values and PD-L1 expression in HNSCC.
- To determine if quantitative MRI parameters can non-invasively predict PD-L1 levels in HNSCC.
- To explore the potential of ADC values in guiding immunotherapy decisions for HNSCC patients.
Main Methods:
- 29 HNSCC patients underwent 3 Tesla MRI with DWI (b-values 0 and 800 s/mm²).
- Whole-lesion apparent diffusion coefficient (ADC) values were quantified using histogram analysis.
- PD-L1 expression was assessed via tumor positive score (TPS), immune cell score (ICS), and combined positive score (CPS) on pre-treatment biopsies.
Main Results:
- A significant inverse correlation was found between ADC skewness and immune cell score (ICS) (r = -0.38, p = 0.04).
- ADCmax showed a trend towards inverse correlation with ICS (r = -0.35, p = 0.06).
- No other ADC parameters demonstrated a significant association with PD-L1 scores (TPS, CPS).
Conclusions:
- A weak association exists between ADC skewness and PD-L1 expression (ICS) in HNSCC.
- Current ADC parameters derived from DWI are likely insufficient for reliably predicting PD-L1 expression in clinical practice.
- Tumor histopathology complexity, beyond immune cell infiltration, may influence ADC values more significantly.
