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European Radiology

, Volume 30, Issue 1, pp 110–118 | Cite as

Differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal lymphoma based on DCE-MRI and RESOLVE-DWI

  • Chengru Song
  • Peng Cheng
  • Jingliang ChengEmail author
  • Yong Zhang
  • Mengtian Sun
  • Shanshan Xie
  • Xiaonan Zhang
Head and Neck

Abstract

Objectives

To explore the utility of dynamic contrast-enhanced MRI (DCE-MRI) and readout-segmented diffusion-weighted imaging (RESOLVE-DWI) in the differentiation of nasopharyngeal carcinoma (NPC) and nasopharyngeal lymphoma (NPL).

Methods

Sixty-two patients with NPC and 39 patients with NPL who underwent DCE-MRI and RESOLVE-DWI examinations were evaluated. The time signal–intensity curve (TIC) types, time to peak (TTP), enhancement peak (EP), maximum contrast enhancement ratio (MCER), washout ratio (WR), apparent diffusion coefficient (ADC), and relative ADC (rADC) values were calculated. Statistical analysis between the two groups was performed to determine the statistical significance of each parameter. Receiver operating characteristic (ROC) curve analysis and binary logistic regression analysis were used to assess the diagnostic ability of single and combined metrics for distinguishing NPC from NPL.

Results

The most common TIC curve was type III in patients with NPC (n = 26), while the majority of the curves were types I (n = 14) and II (n = 19) in patients with NPL. TTP, EP, MCER, ADC, and rADC were statistically significantly different between NPCs and NPLs (p < 0.05). Among these factors, ADC revealed the most reliable diagnostic performance, followed by rADC, TTP, MCER, and EP. Moreover, the diagnostic efficiency of the combined DCE-MRI parameters was higher than that of TTP, MCER, and EP each alone. In addition, the combination of all DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency (area under the curve = 0.961). However, none of the parameters was significantly different between keratinising NPC and non-keratinising NPC or between NK/T lymphoma and diffuse large B cell lymphoma (all p > 0.05).

Conclusion

DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPL.

Key Points

• RESOLVE offers high image quality in the head and neck regions.

• Dynamic contrast-enhanced MRI and RESOLVE-DWI help clinicians to make the differential diagnosis between NPC and NPL.

• The combination of all the DCE-MRI and DWI parameters together demonstrated the highest diagnostic efficiency compared with each parameter alone.

Keywords

Nasopharyngeal carcinoma Lymphoma Magnetic resonance imaging Diffusion magnetic resonance imaging 

Abbreviations

EES

Extravascular extracellular space

EP

Enhancement peak

Gd-DTPA

Gadolinium–diethylenetriamine pentaacetic acid

MCER

Maximum contrast enhancement ratio

MVD

Microvessel density

NPC

Nasopharyngeal carcinoma

NPL

Nasopharyngeal lymphoma

PCNA

Proliferating cell nuclear antigen

rADC

Relative apparent diffusion coefficient

RESOLVE-DWI

Readout-segmented diffusion-weighted imaging

SS-EPI

Single-shot echo-planar imaging

TE

Echo time

TICs

Time signal–intensity curves

TR

Repetition time

TTP

Time to peak

WR

Washout ratio

Notes

Acknowledgements

The authors wish to thank the patients for participating in this study. This work was supported by the First Affiliated Hospital of Zhengzhou University.

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Chengru Song.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• diagnostic study

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Chengru Song
    • 1
  • Peng Cheng
    • 2
  • Jingliang Cheng
    • 1
    Email author
  • Yong Zhang
    • 1
  • Mengtian Sun
    • 1
  • Shanshan Xie
    • 1
  • Xiaonan Zhang
    • 1
  1. 1.Department of MRIThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouPeople’s Republic of China
  2. 2.Department of RadiotherapyHenan Provincial People’s HospitalZhengzhouPeople’s Republic of China

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