Whole-tumour histogram analysis of pharmacokinetic parameters from dynamic contrast-enhanced MRI in resectable oesophageal squamous cell carcinoma can predict T-stage and regional lymph node metastasis

Publication date: Available online 14 January 2019

Source: European Journal of Radiology

Author(s): Yan-li Chen, Rui Li, Tian-wu Chen, Jing Ou, Xiao-ming Zhang, Fan Chen, Lan Wu, Yu Jiang, Maxwell Laws, Kamran Shah, Bobby Joseph, Jiani Hu

Abstract

Objective

To identify whether whole-tumour histogram analysis of pharmacokinetic parameters from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could predict T-stage and regional lymph node metastasis (LNM) of resectable oesophageal squamous cell carcinoma (SCC).

Materials and methods

Forty-two consecutive patients with confirmed oesophageal SCC underwent thoracic DCE-MRI. Histogram metrics (median, mean, standard deviation [SD], skewness, kurtosis and entropy) of whole-tumour pharmacokinetic parameters including endothelial transfer constant (K^trans), reflux rate (K_ep) and fractional extravascular extracellular space volume (V_e) were generated by the Omni-Kinetics software. Histogram datasets were interpreted using the Mann-Whitney U test and receiver operating characteristic (ROC) statistical analyses.

Results

The Mann-Whitney U tests revealed that the median, mean and SD of K^trans, the SD and entropy of K_ep, and the median, mean and entropy of V_e of T1-2 stage oesophageal SCC were lower when compared with T3 stage (all Ps < 0.05); and the ROC analysis showed that the entropy of V_e could reliably distinguish T1-2 stage from T3 stage with an area under ROC (AUC) of 0.773. The Mann-Whitney U tests illustrated that the entropy of K^trans, and the median, mean, SD and entropy of K_ep were higher while the skewness of K_ep was lower in tumours with LNM than without LNM (all Ps < 0.05); and the ROC analysis showed demonstrated that the SD of K_ep could best identify tumours with LNM with an AUC of 0.702.

Conclusion

Whole-tumour histogram analysis of pharmacokinetic parameters of oesophageal SCC on DCE-MRI could be used to predict T-stage and regional LNM.

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