Application Value Of DCE-MRI Quantitative Parameter Histogram Analysis In Evaluating The Staging Of Nasopharyngeal Carcinoma

Objective:The purpose of the study was to investigate the relationship between the results of DCE-MRI quantitative parameter histogram analysis and T,N,M staging and clinical staging of nasopharyngeal carcinoma.Material and Methods:The study consists 72 patients with nasopharyngeal carcinoma confirmed by pathology from March 2018 to January 2019.There were 56 males and 16 females and an average age was 48.43 ±10.95 years.All patients with nasopharyngeal carcinoma were examined by routine MRI and DCE-MRI before treatment.ROI was drawn at the largest level of the lesion by using Omni Kinetics(OK)post-processing software,and the quantitative parameters were obtained:Ktrans,Kep,Ve,Vp.Then we get the results of each quantitative parameter histogram analysis,including 10 th,25th,50 th,75th,90 th percentile,maximum,minimum,median,mean,kurtosis and skewness.All patients were TNM staged and clinical staged according to AJCC 8th edition and Chinese nasopharyngeal carcinoma staging 2017 standard by radiotherapy physician.All data were analyzed by SPSS26.0.All measurement data are expressed as mean ±standard deviation.Univariate ANOVA analysis was used to analyze the differences of age(continuous variables,quantitative data)of patients with NPC with high and low T stages,and x2 test was used for the differences of gender,pathological types and EBV infection(classified variables,qualitative data).Spearman analysis was used to evaluate the correlation between the results of DCE-MRI quantitative parameter histogram and T stage,N stage,M stage and clinical stage of nasopharyngeal carcinoma.The parameters related to the total clinical stage were compared between different clinical stages with multiple independent samples non-parametric test Kruskal-Wallis H test.When P < 0.05,it is statistically significant.Results:1.A total of 72 patients with nasopharyngeal carcinoma were included.According to TNM staging。There were 14 cases of T1,10 cases of T2,37 cases of T3,11 cases of T4,12 cases of N1,47 cases of N2,13 cases of N3,68 cases of M0 and 4cases of M1.According to the total clinical stage,stage Ⅰ: 0 cases,stage Ⅱ: 3 cases,stage Ⅲ: 45 cases,stage Ⅳ: 24 cases.2.T1 and T2 were divided into low T stage group,and T3 and T4 were classified as high T stage group.There were no significant differences in gender,age,EB virus infection and pathological classification between the two groups(P>0.05).3.There was a correlation between the average value of DCE-MRI Ktrans histogram analysis and T stages(r=0.455,P=0.045).4.Dynamic contrast enhancement(DCE-MRI)quantitative parameter histogram analysis showed that Ktrans,Kep,Ve and Vp were not significantly correlated with N staging and M staging.5.There was a correlation between clinical staging and Dynamic contrast enhancement(DCE-MRI)quantitative parameters of histogram analysis,including maximum Ktrans value(r = 0.24,P = 0.042),median(r = 0.233,P = 0.049),75%digits(r = 0.262,P = 0.026),90% digits(r = 0.254,P = 0.031),skewness(r = 0.237,P= 0.045),kurtosis(r = 0.368,P = 0.001)and median of Ve(r = 0.254,P = 0.031).6.The differences of skewness and kurtosis of Ktrans value in stage Ⅱ,stage Ⅲ and stage IV were statistically significant(P=0.038、0.006).There was no significant difference in the maximum,median,75 th and 90 th digits of KTO value and the median of Ve in stage Ⅱ,stage Ⅲ and stage IV(P >0.05).The skewness and kurtosis of Ktrans decreased with the increase of clinical stage,while the maximum,median,75 th digit,90 th digit and median value of Ve increased with the increase of clinical stage.Conclusions:1、 The kurtosis and skewness of DCE-MRI quantitative parameter KT reflect the invasiveness of nasopharyngeal carcinoma,and it is the most potential and valuable parameter to evaluate the accurate staging of nasopharyngeal carcinoma.2、The results of dynamic enhanced quantitative parameter histogram analysis showed that multiple parameters were related to the staging of nasopharyngeal carcinoma,which could reflect the characteristics of microperfusion and microvascular permeability in the tumor,and could assist in the differentiation of T staging and clinical staging of nasopharyngeal carcinoma.to provide a research method for the study of tumor heterogeneity and hemodynamic information of nasopharyngeal carcinoma.3、The stage of nasopharyngeal carcinoma is higher,the heterogeneity in the tumor tissue is more obvious.