Abstract
This study aimed to determine whether dynamic contrast-enhanced MRI (DCE-MRI) derived parameters can identify oesophageal squamous cell carcinoma (SCC) and lymphatic metastasis. Thirty-nine oesophageal SCC patients underwent DCE-MRI. Quantitative parameters including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume and fractional plasma volume, and semi-quantitative parameters including time to peak (TTP), max concentration, Max Slope and area under concentration-time curve of both oesophageal SCC and normal oesophagus were measured. Mann-Whitney U test revealed that Ktrans and Kep of oesophageal SCC were higher while TTP was shorter when compared to normal oesophagus (all P-values < 0.05); and areas under receiver operating characteristic [ROC] curves displayed that Kep was superior to TTP or Ktrans for identifying oesophageal SCC (0.903 vs. 0.832 or 0.713). Mann-Whitney U test also demonstrated that Kep was higher and TTP was shorter in patients with lymphatic metastasis when compared to non-metastatic cancer patients (both P-values < 0.05), and area under ROC curve also showed that TTP was superior to Kep for predicting lymphatic metastasis (0.696 vs. 0.659). In conclusion, the combination of quantitative and semi-quantitative parameters derived from DCE-MRI can aid in the identification of oesophageal SCC and lymphatic metastasis.
Highlights
This study aimed to determine whether dynamic contrast-enhanced Magnetic resonance imaging (MRI) (DCE-MRI) derived parameters can identify oesophageal squamous cell carcinoma (SCC) and lymphatic metastasis
Mann-Whitney U test revealed that Ktrans and Kep of oesophageal SCC were higher while time to peak (TTP) was shorter when compared to normal oesophagus; and areas under receiver operating characteristic [ROC] curves displayed that Kep was superior to TTP or Ktrans for identifying oesophageal SCC (0.903 vs. 0.832 or 0.713)
Mann-Whitney U test demonstrated that Kep was higher and TTP was shorter in patients with lymphatic metastasis when compared to non-metastatic cancer patients, and area under ROC curve showed that TTP was superior to Kep for predicting lymphatic metastasis (0.696 vs. 0.659)
Summary
This study aimed to determine whether dynamic contrast-enhanced MRI (DCE-MRI) derived parameters can identify oesophageal squamous cell carcinoma (SCC) and lymphatic metastasis. The development of perfusion computed tomography (CT) has made it possible to capture the parameters reflecting the vasculature of oesophageal SCC, facilitating the identification of oesophageal SCC It has made lymphatic metastasis more predictable[3,4]. DCE-MRI can visually judge the enhancement of a region of interest and semi-quantitatively characterize tumours by analyzing the signal variation with respect to time, and can quantitatively evaluate tumours with parameters derived from pharmacokinetic models, which demonstrates the dynamic distribution of gadolinium-related contrast agent in the different compartments of the tumour[12,13,14,15]. There were no publications regarding the combination of quantitative and semi-quantitative parameters derived from DCE-MRI to identify resectable oesophageal SCC and predicting status of lymphatic metastasis. The present study was undertaken to evaluate the feasibility of DCE-MRI for the discrimination of microcirculation differences between oesophageal SCC and the normal oesophagus and between oesophageal SCC with and without lymph node metastasis
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