Intravoxel incoherent motion MR imaging in nasopharyngeal carcinoma: comparison and correlation with dynamic contrast enhanced MR imaging
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Vincent Lai1, Victor Ho Fun Lee2, Ka On Lam2, Bingsheng Huang3, Queenie Chan4 and Pek Lan Khong1
1Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
2Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
3Department of Biomedical Engineering, School of Medicine, Shenzhen University, Shenzhen, China
4Philips Healthcare, Hong Kong, China
Vincent Lai, email: [email protected]
Keywords: nasopharyngeal carcinoma, intravoxel incoherent motion, dynamic contrast enhanced, magnetic resonance imaging, tumor staging
Received: February 18, 2017 Accepted: June 27, 2017 Published: July 26, 2017
Objectives: To compare accuracy and assess agreement between intravoxel incoherent motion (IVIM) magnetic resonance (MR) perfusion-related parameters and quantitative dynamic contrast-enhanced (DCE) MR parameters in nasopharyngeal carcinoma (NPC).
Results: D, f, D*, Ktrans, Kep and Vp were significantly lower in the high stage group while Ve was significantly higher in the high stage group. Optimal cut-off values were: D=0.749 x 10-3 mm2/s; f=0.145; D*=100.401 x 10-3 mm2/s; Ktrans=0.571/min; Kep=0.8196/min; Ve=0.6556 %; Vp=0.0757 %. D* (p=0.001), Ktrans (p<0.001), Ve (p=0.014) were all reliable independent predictors for AJCC staging. IVIM-MR perfusion-related (f, D*) and DCE-MR (Ktrans, Kep, Ve, Vp) parameters were significantly correlated (p<0.001).
Materials and Methods: 75 patients with newly diagnosed NPC were prospectively recruited. Diffusion-weighted MR and DCE-MR imaging were performed with respective IVIM (D, f, D*) and DCE (Ktrans, Kep, Ve, Vp) MR parameters calculated. Patients were stratified into low and high tumor stage groups according to American Joint Committee on Cancer (AJCC) staging for determination of the predictive powers of IVIM-MR and DCE-MR parameters using t–test, ROC curve analyses and multiple logistic regression analysis. Correlation between IVIM-MR perfusion-related and DCE-MR parameters was assessed using Spearman’s rank correlation.
Conclusion: IVIM-MR perfusion-related and quantitative DCE-MR parameters were significantly correlated in the assessment of NPC and were both reliable independent predictors in the prediction of AJCC staging. IVIM-MR perfusion imaging can be a potential useful non-invasive perfusion imaging tool for clinical use in the assessment of NPC.
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