Research Papers:

Histogram analysis parameters of apparent diffusion coefficient reflect tumor cellularity and proliferation activity in head and neck squamous cell carcinoma

Alexey Surov _, Hans Jonas Meyer, Karsten Winter, Cindy Richter and Anna-Kathrin Hoehn

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Oncotarget. 2018; 9:23599-23607. https://doi.org/10.18632/oncotarget.25284

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Alexey Surov1,*, Hans Jonas Meyer1,*, Karsten Winter2, Cindy Richter2 and Anna-Kathrin Hoehn3

1Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Leipzig 04103, Germany

2Institute of Anatomy, University Hospital of Leipzig, Leipzig 04103, Germany

3Department of Pathology, University Hospital of Leipzig, Leipzig 04103, Germany

*These authors contributed equally to this work

Correspondence to:

Alexey Surov, email: [email protected]

Keywords: MRI; ADC; histogram analysis; KI 67; HNSCC

Abbreviations: MRI: magnetic resonance imaging; DWI: diffusion weighted imaging; ADC: apparent diffusion coefficient; HNSCC: head and neck squamous cell carcinoma; ROI: region of interest

Received: January 24, 2018     Accepted: April 06, 2018     Published: May 04, 2018


Our purpose was to analyze associations between apparent diffusion coefficient (ADC) histogram analysis parameters and histopathologicalfeatures in head and neck squamous cell carcinoma (HNSCC).

The study involved 32 patients with primary HNSCC. For every tumor, the following histogram analysis parameters were calculated: ADCmean, ADCmax, ADCmin, ADCmedian, ADCmode, P10, P25, P75, P90, kurtosis, skewness, and entropy. Furthermore, proliferation index KI 67, cell count, total and average nucleic areas were estimated. Spearman's correlation coefficient (p) was used to analyze associations between investigated parameters.

In overall sample, all ADC values showed moderate inverse correlations with KI 67. All ADC values except ADCmax correlated inversely with tumor cellularity. Slightly correlations were identified between total/average nucleic area and ADCmean, ADCmin, ADCmedian, and P25.

In G1/2 tumors, only ADCmode correlated well with Ki67. No statistically significant correlations between ADC parameters and cellularity were found.

In G3 tumors, Ki 67 correlated with all ADC parameters except ADCmode. Cell count correlated well with all ADC parameters except ADCmax. Total nucleic area correlated inversely with ADCmean, ADCmin, ADCmedian, P25, and P90.

ADC histogram parameters reflect proliferation potential and cellularity in HNSCC. The associations between histopathology and imaging depend on tumor grading.

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