Quantitative dynamic contrast-enhanced MR imaging can be used to predict the pathologic stages of oral tongue squamous c
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RESEARCH ARTICLE
Open Access
Quantitative dynamic contrast‑enhanced MR imaging can be used to predict the pathologic stages of oral tongue squamous cell carcinoma Na Guo1,3†, Weike Zeng1†, Hong Deng1†, Huijun Hu1, Ziliang Cheng1,2, Zehong Yang1,2, Shuqi Jiang1, Xiaohui Duan1,2* and Jun Shen1,2*
Abstract Background: To investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC). Methods: For this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including Ktrans, Kep, Ve, and Vp, were derived from DCE-MRI by utilizing a twocompartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I–II and stage III–IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance. Results: The mean Ktrans, Kep and Vp values were significantly lower in stage III–IV lesions compared with stage I–II lesions (p = 0.013, 0.005 and 0.011, respectively). Kep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that K ep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%. Conclusion: The quantitative DCE-MRI parameter Kep can be used as a biomarker for predicting pathologic stages of OTSCC. Keywords: Tongue neoplasms, Squamous cell carcinoma, Magnetic resonance imaging, Contrast media, Neoplasm staging
*Correspondence: duanxiaohui‑[email protected]; [email protected] † Na Guo, Weike Zeng and Hong Deng contributed equally to this work 1 Department of Radiology, Sun Yat‑Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China Full list of author information is available at the end of the article
Background Oral tongue squamous cell carcinoma (OTSCC) is the most common malignancy of the oral cavity and comprises 25–40% of oral carcinomas [1]. It has a more aggressive clinical behavior and a relatively poor prognosis compared with other oral cavity and head and neck cancers [2]. However, the prognosis of OTSCC in early disease (TNM stage I–II) is better than that of advanced disease (TNM stage III–IV). For example, the five-year survival rate in patients with stage I disease exceeds 80%
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or form
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