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Histogram analysis of arterial spin labeling perfusion data to determine the human papillomavirus status of oropharyngeal squamous cell carcinomas

  • Head-Neck-ENT Radiology
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Abstract

Purpose

To evaluate the correlation between histogram parameters derived from pseudo-continuous arterial spin labeling (PCASL) and human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (OPSCC).

Methods

This study included a total of 58 patients (HPV-positive: n = 45; -negative: n = 13) from a prospective cohort of consecutive patients aged ≥ 18 years, who were newly diagnosed with oropharyngeal squamous cell carcinoma. All patients were required to have undergone pre-treatment MRI with PCASL to measure regional perfusion. The region of interest was drawn by two radiologists, encompassing the entire tumor volume on all corresponding slices. Differences in the histogram parameters derived from tumor blood flow (TBF) in ASL were assessed for HPV-positive and -negative patients. Receiver operating characteristic curve analysis was performed to determine the best differentiating parameters, and a leave-one-out cross-validation was used.

Results

Patients with HPV-positive OPSCC showed a significantly lower overall standard deviation and 95th percentile value of tumor blood flow (P < .007). The standard deviation of TBF was the single best predictive parameter. Leave-one-out cross-validation tests revealed that the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity were 0.745, 75.9%, 75.6%, and 76.9%, respectively.

Conclusion

PCASL revealed differences in perfusion parameters according to HPV status in patients with OPSCC, reflecting their distinct histopathology.

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Abbreviations

ASL:

Arterial spin labeling

EGFR:

Epidermal growth factor receptor

HPV:

Human papillomavirus

OPSCC:

Oropharyngeal squamous cell carcinoma

PCASL:

Pseudo-continuous arterial spin labeling

ROC:

Receiver operating characteristic

SD:

Standard deviation

CV:

Coefficient of variance

TBF:

Tumor blood flow

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Funding

No direct funding was received for the work presented in this manuscript.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea

    Yura Ahn, Young Jun Choi, Yu Sub Sung, Chong Hyun Suh, Sae Rom Chung, Jung Hwan Baek & Jeong Hyun Lee

  2. Siemens Healthcare, MR Application Development, Erlangen, Germany

    Josef Pfeuffer

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  1. Yura Ahn
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Correspondence to Young Jun Choi.

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Ahn, Y., Choi, Y.J., Sung, Y.S. et al. Histogram analysis of arterial spin labeling perfusion data to determine the human papillomavirus status of oropharyngeal squamous cell carcinomas. Neuroradiology 63, 1345–1352 (2021). https://doi.org/10.1007/s00234-021-02751-6

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