Three-dimensional pulsed continuous arterial spin labeling and intravoxel incoherent motion imaging of nasopharyngeal carcinoma: correlations with Ki-67 proliferation status

Abstract

Background: Recurrence and distant metastasis are still the main problems affecting the long-term prognosis of nasopharyngeal carcinoma (NPC) patients, and may be related to the Ki-67 proliferation status. We therefore explored the potential correlation between Ki-67 proliferation status in NPC with the parameters derived from two imaging techniques: three-dimensional pulsed continuous arterial spin labeling (3D pCASL) and intravoxel incoherent motion (IVIM).Methods: Thirty-six patients with pathologically confirmed NPC were included, and the Ki-67 labeling index (LI) was measured by immunohistochemistry. All patients underwent plain and contrast-enhanced magnetic resonance imaging (MRI), IVIM, and 3D pCASL examination. The mean, maximum, and minimum of blood flow (BF), minimum of apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) parameters were all measured, and Spearman's correlation analysis was performed to evaluate the relationships between these parameters and the Ki-67 LI.According to the Ki-67 values, the patients were divided into two groups: high (>50%) and low (≤50%). The rank-sum test (Mann-Whitney U test) was then used to compare the differences in quantitative parameters between the high and low Ki-67 groups.Results: Ki-67 LI was positively correlated with BF mean and BF max (r=0.415 and 0.425). D* mean and D* min did have positive correlation with Ki-67, but this was not significant (P=0.082 and 0.072). BF max was significantly different between the high and low Ki-67 groups (P=0.028).Conclusions: 3D pCASL and IVIM are noninvasive functional MR perfusion imaging techniques that can evaluate perfusion information and perfusion parameters. Our study suggests that 3D pCASL is more effective than IVIM for assessing the proliferation status of NPC, which is beneficial for evaluating the prognosis of patients. Furthermore, BF max is the best biomarker for distinguishing high from low Ki-67 levels.

Identification of histological features of endometrioid adenocarcinoma based on amide proton transfer-weighted imaging and multimodel diffusion-weighted imaging

“…In this study, except for D*, all other parameters showed different degrees of correlation with the Ki-67 index. One possible explanation for this finding is that a high Ki-67 index correlates with increased cell proliferation, which tends to correlate with higher cellular density, more vascular hyperplasia, and more histologic heterogeneity (36)(37)(38).…”

The Prediction of Biological Features Using Magnetic Resonance Imaging in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

“…Four studies [60,61,63,65] directly investigated the correlation and found a significant inverse association (partial correlation r = −0.253 to r = −0.728; p < 0.001-0.024). In contrast, Wu et al [71] reported a positive but non-significant correlation between ADC mean and Ki-67 (r = 0.238; p = 0.163). An overall effect of COR (−0.37, 95%CI −0.65-0.00; p = 0.051) was calculated; see Figure 4 for the forest plot.…”

“…The associations between the Ki-67 proliferation index and the DWI-metric ADC mean were examined in six studies [60,61,63,65,71,72]. Four studies [60,61,63,65] directly investigated the correlation and found a significant inverse association (partial correlation r = −0.253 to r = −0.728; p < 0.001-0.024).…”

Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy

“…Three-dimensional pulsed continuous arterial spin labeling (3D-pCASL) technology safely and non-invasively evaluates tissue perfusion without the use of a contrast agent. Instead, freely diffusing water molecules are used as endogenous contrast agents (9). Diffusion-weighted imaging (DWI) provides insights into the cellular structure and is sensitive to the heat-driven motion of water molecules in tissues (6).…”

“…Therefore, DWI accurately reflects the state of radiation-induced cell inactivation. Intrixel incoherent motion imaging (IVIM) is a further development of DWI, capable of delivering both diffusion and perfusion imaging results without the need for contrast injection, with the advantage of being completely non-invasive (9,10). IVIM has been widely used in hepatic fibrosis evaluation (11), staging (9,10), efficacy evaluation (12), the differential diagnosis of fibrosis, and monitoring of NPC recurrence following RT (13).…”