Dynamic contrast-enhanced magnetic resonance imaging for characterising nasopharyngeal carcinoma: comparison of semiquantitative and quantitative parameters and correlation with tumour stage

Abstract

Objectives: To evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for characterising nasopharyngeal carcinoma (NPC).

Methods: Forty-five newly diagnosed NPC patients were recruited. The initial enhancement rate (E R ), contrast transfer rate (k ep ), elimination rate (k el ), maximal enhancement (MaxEn) and initial area under the curve (iAUC) were calculated from semiquantitative analysis. The K (trans) (volume transfer constant), v e (volume fraction) and k ep were calculated from quantitative analysis. Student's t-test was used to evaluate the differences among tumour stages. Pearson's correlation between the two sets of k ep was performed.

Results: Comparing tumours of T1/2 stage (n = 18) and T3/4 stage (n = 27), MaxEn (P = 0.030) and iAUC (P = 0.039) were both significantly different; however, the iAUC was the only independent variable with 69.6 % sensitivity and 76.5 % specificity respectively; v e was also significantly different (P = 0.010) with 69.6 % sensitivity and 70.6 % specificity respectively. No significant difference was found among N stages. The two sets of k ep s were highly correlated (r = 0.809, P < 0.001). Forty-three patients had chemoradiation, one palliative chemotherapy and one radiotherapy only. In the four patients with poor outcome, k el, E R, MaxEn and iAUC tended to be higher.

Conclusions: Neovasculature in higher T stage NPC exhibits some parameters of increased permeability and perfusion. Thus, DCE-MRI may be helpful as an adjunctive technique in evaluating NPC.

Key points: • The correct assessment of nasopharyngeal carcinoma (NPC) is important for planning treatment. • Neovasculature in higher T stage NPC exhibits increased permeability and perfusion. • Correlation between quantitative and semi-quantitative analysis validates the robustness of DCE-MRI. • DCE-MRI may be helpful as an adjunctive parameter in evaluating NPC.