The Value Of ADC And ADC-MRI Histogram Analysis In Predicting The Pathological Grades Of ESCC

Objective1.To evaluate the value of apparent diffusion coefficient?ADC?histogram analysis in predicting the pathological grades of esophageal squamous cell carcinoma?ESCC?.2.This study was designed to quantitatively evaluate and predict the pathological grades of ESCC using dynamic contrast-enhanced magnetic resonance imaging?DCE-MRI?histogram analysis.Material and Methods1.Preoperative diffusion-weighted MR imaging?DWI?of the patients?n=59?with ESCC were retrospectively analyzed.32 patients were included in this study and divided into 16 low-grade I or II and 16 high-grade III ESCC groups.ADC histogram parameters of the entire tumor volume including ADC₁₀,ADC₂₅,ADC₅₀,ADC₇₅,ADC₉₀,ADC_mean,kurtosis,skewness were determined.The parameters of the low-and high-grade groups were compared using two indepent sample t-test and receiver operating characteristic?ROC?curves.2.Preoperative DCE-MRI data of 59 patientswith ESCC were retrospectively analyzed.32 patients were recruited in this study and divided into two groups,low-grade group?G1-G2,n=16?and high-grade group?G3,n=16?.Histogram parameters based on the entire tumor volume of K^trans,K_ep,V_e and V_p included mean,10^th,25^th,50^th,75^th and 90th percentile values.Independent sample's t-test or Mann-Whitney U test was used to compare the parameters between the two groups.Receiver operating characteristic curves?ROC?were used to determine the diagnostic value of each significant parameter and areas under the curve?AUC? were calculated.Result:1.The mean values of ADC₁₀(1.49±0.33×10^-3 mm²/s)and ADC₂₅?1.67±0.32×10^-3mm²/s?in the high-grade group were significantly?P=0.006 and 0.044,respectively?higher than that in the low-grade group?1.10±0.41×10-3 mm2/s,1.37±0.47×10-3 mm2/s?.ROC analyses showed that ADC10 was optimal for predicting high-grade ESCC with area under the curve of 0.78,75%sensitivity and 81.25%specificity.2.The values of K_mean^trans,K₇₅^trans,K₉₀^trans,and V_p90 in the high-grade group were higher than those in the low-grade group?P<0.05?.The AUCs were 0.711,0.711,0.852,and 0.723,respectively.The K₉₀^trans's sensitivity and specificity were 81.25%and 75.00%,respectively.Conclusion:1.Histogram analysis of ADC maps of the whole tumor volume is useful in differentiating pathological grades of ESCC.2.K₉₀^trans,derived from DCE-MRI histogram analysis based on the entire tumor,was more powerful than K_mean^trans in differentiating and valuable in prdicting pathological grades of ESCC.