Distinguishing early-stage nasopharyngeal carcinoma from benign hyperplasia using intravoxel incoherent motion diffusion-weighted MRI
Publication in refereed journal


摘要Objectives MRI can detect early-stage nasopharyngeal carcinoma (NPC), but the detection is more challenging in early-stage NPCs because they must be distinguished from benign hyperplasia in the nasopharynx. This study aimed to determine whether intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) MRI could distinguish between these two entities. Methods Thirty-four subjects with early-stage NPC and 30 subjects with benign hyperplasia prospectively underwent IVIM DWI. The mean pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) values were calculated for all subjects and compared between the 2 groups using Student's t test. Receiver operating characteristics with the area under the curve (AUC) was used to identify the optimal threshold for all significant parameters, and the corresponding diagnostic performance was calculated. A p value of < 0.05 was considered statistically significant. Results Compared with benign hyperplasia, early-stage NPC exhibited a significantly lower D mean (0.64 +/- 0.06 vs 0.87 +/- 0.11 x 10(-3) mm(2)/s), ADC(0-1000) mean (0.77 +/- 0.08 vs 1.00 +/- 0.13 x 10(-3) mm(2)/s), ADC(300-1000) (0.63 +/- 0.05 vs 0.86 +/- 0.10 x 10(-3) mm(2)/s) and a higher D* mean (32.66 +/- 4.79 vs 21.96 +/- 5.21 x 10(-3) mm(2)/s) (all p < 0.001). No significant difference in the f mean was observed between the two groups (p = 0.216). The D and ADC(300-1000) mean had the highest AUC of 0.985 and 0.988, respectively, and the D mean of < 0.75 x 10(-3) mm(2)/s yielded the highest sensitivity, specificity and accuracy (100%, 93.3% and 96.9%, respectively) in distinguishing early-stage NPC from benign hyperplasia. Conclusion DWI has potential to distinguish early-stage NPC from benign hyperplasia and D and ADC(300-1000) mean were the most promising parameters.
著者Ai QY, King AD, Chan JSM, Chen WT, Chan JCA, Woo JKS, Zee BCY, Chan ATC, Poon DMC, Ma BBY, Hui EP, Ahuja AT, Vlantis AC, Yuan J
期刊名稱European Radiology
出版社Springer Verlag
頁次5627 - 5634
關鍵詞Diffusion magnetic resonance imaging, Nasopharyngeal carcinoma, Hyperplasia

上次更新時間 2020-06-07 於 02:36