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The value of time-dependent diffusion MRI in nasopharyngeal carcinoma: correlation with prognostic factors
Haoran Wei1, Fan Yang1, Sai Wang1
1Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Objectives:
To evaluate the correlation between time-dependent diffusion MRI (td-dMRI) parameters and prognostic factors in nasopharyngeal carcinoma (NPC).
Materials And Methods:
116 patients (105 NPC, 11 benign hyperplasia) were prospectively enrolled. Four td-dMRI-derived microstructural parameters, extracellular diffusivity (Dex), intracellular volume fraction (Vin), Diameter, and Cellularity, and apparent diffusion coefficient (ADC) at three oscillation frequencies (ADC0Hz, ADC30Hz, and ADC55Hz), were obtained. TNM stages and prognostic factors were recorded; continuous variables were dichotomized by optimal cut-offs. Correlations, between-group comparisons, and receiver operating characteristic analysis summarized diagnostic performance as the area under the curve (AUC).
Results:
Programmed death ligand 1 was correlated with ADC values, with ADC55Hz achieving an AUC of 0.708. Epidermal growth factor receptor was correlated with Cellularity and Diameter (r = 0.341 and -0.329). Ki-67 expression was associated with Dex and ADC55Hz (r = 0.252 and 0.286). Vin, Cellularity and ADC0/30Hz were linked to histological subtype, with Vin achieving the highest AUC of 0.706. TNM stages were correlated with Diameter (r = 0.203 to 0.371) and Cellularity (r = -0.365 to -0.284). ADC30Hz best distinguished NPC (T1-2) from hyperplasia (AUC = 0.847). Negative correlations were observed between several parameters and Epstein-Barr virus (EBV)-based antibodies (r = -0.269 to -0.239). Vin and ADC0/30Hz differed across EBV DNA clearance groups after induction chemoimmunotherapy (p ≤ 0.038). td-dMRI-measured diameters correlated with pathological measurements (r = 0.772, p < 0.001).
Conclusions:
td-dMRI parameters may reflect tumor microstructure and show associations with prognostic factors in NPC, suggesting potential utility for risk stratification and treatment monitoring.
Key Points:
Question Can microstructural parameters from time-dependent diffusion MRI (td-dMRI) noninvasively provide clinically meaningful prognostic information for nasopharyngeal carcinoma? Findings Differences in prognostic factor levels can be reflected by td-dMRI, and td-dMRI-derived diameter was correlated with pathology-derived diameter (r = 0.772, p < 0.001). Clinical relevance td-dMRI provides a noninvasive method to characterize tumor microstructure, potentially improving patient management strategies in nasopharyngeal carcinoma.
