The utility of texture analysis based on quantitative synthetic magnetic resonance imaging in nasopharyngeal carcinoma: a preliminary study

Abstract

Background Magnetic resonance imaging (MRI) is commonly used for the diagnosis of nasopharyngeal carcinoma (NPC) and occipital clivus (OC) invasion, but a proportion of lesions may be missed using non-enhanced MRI. The purpose of this study is to investigate the diagnostic performance of synthetic magnetic resonance imaging (SyMRI) in differentiating NPC from nasopharyngeal hyperplasia (NPH), as well as evaluating OC invasion. Methods Fifty-nine patients with NPC and 48 volunteers who underwent SyMRI examination were prospectively enrolled. Eighteen first-order features were extracted from VOIs (primary tumours, benign mucosa, and OC). Statistical comparisons were conducted between groups using the independent-samples t-test and the Mann–Whitney U test to select significant parameters. Multiple diagnostic models were then constructed using multivariate logistic analysis. The diagnostic performance of the models was calculated by receiver operating characteristics (ROC) curve analysis and compared using the DeLong test. Bootstrap and 5-folds cross-validation were applied to avoid overfitting. Results The T1, T2 and PD map-derived models had excellent diagnostic performance in the discrimination between NPC and NPH in volunteers, with area under the curves (AUCs) of 0.975, 0.972 and 0.986, respectively. Besides, SyMRI models also showed excellent performance in distinguishing OC invasion from non-invasion (AUC: 0.913–0.997). Notably, the T1 map-derived model showed the highest diagnostic performance with an AUC, sensitivity, specificity, and accuracy of 0.997, 96.9%, 97.9% and 97.5%, respectively. By using 5-folds cross-validation, the bias-corrected AUCs were 0.965–0.984 in discriminating NPC from NPH and 0.889–0.975 in discriminating OC invasion from OC non-invasion. Conclusions SyMRI combined with first-order parameters showed excellent performance in differentiating NPC from NPH, as well as discriminating OC invasion from non-invasion.

T1 and T2 mapping for identifying malignant lymph nodes in head and neck squamous cell carcinoma

“…Within other clinical investigations, a higher T1 has been associated with higher-risk histopathologic features and dismal prognosis [ 15 , 16 , 39 , 40 ], with one report noting elevated T1 values for malignant lesions than benign lesions [ 41 ]. Additionally, radiological features derived from T1 mapping, as explored through radiomics techniques, have been recently found valuable in predicting Gleason scores in prostate cancer [ 42 ] and distinguishing between benign and malignant lesions in the nasopharynx [ 43 ]. The significantly higher T1 SD for metastatic lymph nodes suggests a more complex heterogeneity inside the metastatic lymph nodes and calls for further exploration of radiomic features on T1 mapping, as mapping methodologies can offer precision on a voxel-by-voxel basis.…”