Quantitative Assessment of Skull-Base Invasion in Nasopharyngeal Carcinoma Patients with Signal Intensity Index Based on Magnetic Resonance Imaging

Yi-Zhuo Li, Chuan-Miao Xie, Yao-Pan Wu, Chun-Yan Cui, Zi-Lin Huang, Ci-Yong Lu, Pei-Hong Wu

Abstract


Purpose: To evaluate the use of signal intensity index (SII) of skull-base invasion in nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI), select a best cut-off SII value to predict the outcome of NPC.
Materials and Methods: One hundred and twenty-two NPC patients (92 men, 30 women) with skull-base invasion were included. All patients underwent MRI, signal intensities on T1-weighted imaging (T1WI) were measured for each invaded site and its contralateral normal counterpart. The SIIs were calculated, receiver operating characteristic curves were constructed. The optimal cut-off values were extracted. The overall survival (OS) rates of 5-year follow-up were performed.
Results: Sensitivities for differentiating skull-base invasion from normal contralateral anatomy were 98.9%, 88.5% and 70.0%, and specificities were 98.9%, 96.0% and 74.4%, respectively. There were three cut-off values for differentiating invasion from normal anatomy of skull-base, 49%, 98%, and 60%. Significant difference in OS rates (84.2% vs. 57.1%, p=0.007) was seen for SII threshold values > 60% and those ≤ 60%.
Conclusions: The SII might be a useful means of differentiating invasion from normal tissue at the skull-base in NPC. The cut-off value of quantitative SII at the skull-base may aid in monitoring the response to treatment of NPC patients.

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References


Heng DM, Wee J, Fong KW, et al. Prognostic factors in 677 patients in Singapore with nondisseminated nasopharyngeal carcinoma. Cancer, 1999,86:1912-20.

Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010; 17:1471-4.

Chong VF, Fan YF. Skull base erosion in nasopharyngeal carcinoma: detection by CT and MRI. Clin Radiol 1996;51:625-31.

Lu JC, Wei Q, Zhang YQ, Li F. Influence of MRI abnormality in skull base bone on prognosis of nasopharyngeal carcinoma. Cancer Radiother 2004; 8:230-3.

Li YZ, Wu PH, Huang ZL,et al. Distributions of primary nasopharyngeal carcinoma tumor and patterns of skull base erosion detected by magnetic resonance imaging. Zhonghua Yi Xue Za Zhi 2010; 90:3347-50.

Chen L, Liu LZ, Mao YP,et al. Grading of MRI-detected skull-base invasion in Nasopharyngeal Carcinoma and its prognostic value. Head & neck 2011;33:1309-14.

Li YZ, Cai PQ, Xie CM,et al. Nasopharyngeal cancer: impact of skull base invasion on patient’s prognosis and its potential implications on TNM staging. Eur J Radiol. 2013; 82:e107–e111.

Li YZ, Xie CM, Wu YP, et al. Nasopharyngeal Carcinoma Patients With Retropharyngeal Lymph Node Metastases: A Minimum Axial Diameter of 6 mm Is a More Accurate Prognostic Predictor Than 5 mm. AJR 2015; 204(1):20-23.

Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. Journal of the American statistical association. 1958; 53:457-81.

Chan SC, Ng SH, Chang JT, et al. Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma: comparison with magnetic resonance imaging. Eur J Nucl Med Mol Imaging. 2006; 33:1032-40.

Liu T, Xu W, Yan WL, et al. MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol. 2007; 85:327-35.

Yen RF, Hung RL, Pan MH, et al.18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging. Cancer. 2003; 98:283-7.

Chan SC, Yen TC, Ng SH,et al. Differential roles of 18F-FDG PET in patients with locoregional advanced nasopharyngeal carcinoma after primary curative therapy: response evaluation and impact on management. J Nucl Med. 2006; 47:1447-54.

Comoretto M, Balestreri L, Borsatti E, et al. Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy: comparison of MR imaging and FDG PET/CT. Radiology. 2008; 249:203-11.

Ng SH, Chan SC, Yen TC,et al. Staging of untreated asopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up. Eur J Nucl Med Mol Imaging.2009; 36:12-22.

King AD, Ma BB, Yau YY, Zee B, Leung SF, Wong JK, et al. The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol 2008;81:291-8.




DOI: http://dx.doi.org/10.15383/jnpc.25

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