Application of dynamic contrast-enhanced MRI to differentiate malignant lymphoma from squamous cell carcinoma in the head and neck

Abstract

Because malignant lymphoma, the second most common malignant tumor of the head and neck, and squamous cell carcinoma (SCC), the most common malignant tumor of the head and neck, require different treatments, it is important to be able to differentiate them. In the present study, we attempted to differentiate malignant lymphomas from SCCs using dynamic contrast-enhanced MRI (DCE-MRI). Seventeen lesions (in 8 cases) of malignant lymphoma and 30 cases of SCC were compared by DCE-MRI.Thirteen of 17 malignant lymphomas (76.5 %) showed the maximum contrast index (CI) at 90-180 s, while 26 of 30 SCCs (86.7%) showed the maximum CI at a much faster 60-105 s. There was a statistically significant difference between SCC and malignant lymphoma in the time needed reach the maximum CI (p=0.0177). There was also significant difference between SCC and malignant lymphoma in their maximum CIs (p<0.001), with the maximum CIs of 29/30 SCCs (96.7%) above 2.0, while 12/17 malignant lymphomas (70.6%) showed CIs of less than 2.0. We consider these findings to be useful for distinguishing lymphomas from SCCs.

Diagnostic value of tumor blood flow and its histogram analysis obtained with pCASL to differentiate sinonasal malignant lymphoma from squamous cell carcinoma

“…However, several studies investigated tumor perfusion-related parameters by using a DCE technique. Asaumi et al reported that high peak signal intensity from the dynamic curve after a bolus injection of contrast agent was obtained from most SCCs, whereas 70% of the ML cases did not show such high peak signal intensity in their dynamic curves [14]. Lee et al reported that the mean plasma volume (which has been related to blood volume) was higher in SCC cases than that in ML cases, although the difference was not significant [12].…”

“…In contrast, tumor perfusion can be useful for the differential diagnosis of SCC and ML as another physiological parameter. Dynamic contrast-enhanced (DCE) perfusion techniques that were reported to be useful for this differentiation use the pattern of the dynamic curve of the tumor concentration of the contrast agent, or the perfusion-related parameters of k-trans, plasma volume, and the volume of extracellular space [12][13][14]. A pseudo-continuous arterial spin labeling (pCASL) technique is now widely used for the noninvasive measurement of tissue blood flow by using protons in arterial water as the intrinsic tracer [15].…”

Quantitative and qualitative characterization of vascularization and hemodynamics in head and neck tumors with a 3D magnetic resonance time-resolved echo-shared angiographic technique (TREAT)—initial results

“…To differentiate HNT according to their dynamic contrast enhancement characteristics with dynamic MRI has been attempted for many tumor entities [16,17]. However, imaging was done using repetitive measurements with 2D T1w GE sequences with a low temporal resolution and a long imaging time post-contrast.…”

Texture analysis on parametric maps derived from dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer

“…By applying pharmacokinetic modeling on sequential T1-weighted images acquired after administration of a contrast agent, one can yield relevant quantitative tumor biomarkers, such as volume transfer rate (K trans ) and volume fraction of the extravascular extracellular space (ve) [2,3] . For patients with advanced head and neck squamous cell carcinoma (HNSCC), DCE-MRI has shown potential for assessment of treatment response and outcome [4][5][6] . More specifically, measures derived from DCE-MRI, such as K trans and ve, were demonstrated to provide helpful additional information regarding characterization and prognosis of HNSCC with neck nodal metastases [7,8] .…”