Utility of mono-exponential, bi-exponential, and stretched exponential signal models of intravoxel incoherent motion (IVIM) to predict prognosis and survival risk in laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) patients after chemoradiotherapy,Japanese Journal of Radiology

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Utility of mono-exponential, bi-exponential, and stretched exponential signal models of intravoxel incoherent motion (IVIM) to predict prognosis and survival risk in laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) patients after chemoradiotherapy
Japanese Journal of Radiology ( IF 2.9 ) Pub Date : 2023-02-27 , DOI: 10.1007/s11604-023-01399-x
Ya Zhang ₁ , Dehong Luo _{1,

2} , Wei Guo ₃ , Zhou Liu ₂ , Xinming Zhao ₁

Affiliation

Purpose

To investigate the predictive power of mono-exponential, bi-exponential, and stretched exponential signal models of intravoxel incoherent motion (IVIM) in prognosis and survival risk of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) patients after chemoradiotherapy.

Materials and methods

Forty-five patients with laryngeal or hypopharyngeal squamous cell carcinoma were retrospectively enrolled. All patients had undergone pretreatment IVIM examination, subsequently, mean apparent diffusion coefficient (ADCmean), maximum ADC (ADCmax), minimum ADC (ADCmin) and ADCrange (ADCmax − ADCmean) by mono-exponential model, true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f) by bi-exponential model, distributed diffusion coefficient (DDC), and diffusion heterogeneity index (α) by stretched exponential model were measured. Survival data were collected for 5 years.

Results

Thirty-one cases were in the treatment failure group and fourteen cases were in the local control group. Significantly lower ADCmean, ADCmax, ADCmin, D, f, and higher D* values were observed in the treatment failure group than in the local control group (p < 0.05). D* had the greatest AUC of 0.802, with sensitivity and specificity of 77.4 and 85.7% when D* was 38.85 × 10^–3 mm²/s. Kaplan–Meier survival analysis showed that the curves of N stage, ADCmean, ADCmax, ADCmin, D, D*, f, DDC, and α values were significant. Multivariate Cox regression analysis showed ADCmean and D* were independently correlated with progression-free survival (PFS) (hazard ratio [HR] = 0.125, p = 0.001; HR = 1.008, p = 0.002, respectively).

Conclusion

The pretreatment parameters of mono-exponential and bi-exponential models were significantly correlated with prognosis of LHSCC, ADCmean and D* values were independent factors for survival risk prediction.

中文翻译：

利用体素内不相干运动 (IVIM) 的单指数、双指数和拉伸指数信号模型预测放化疗后喉和下咽鳞状细胞癌 (LHSCC) 患者的预后和生存风险

目的

目的研究体素内不相干运动 (IVIM) 的单指数、双指数和拉伸指数信号模型对放化疗后喉和下咽鳞状细胞癌 (LHSCC) 患者预后和生存风险的预测能力。

材料和方法

回顾性纳入 45 名喉或下咽鳞状细胞癌患者。所有患者均接受治疗前IVIM检查，随后通过单指数模型计算平均表观扩散系数（ADCmean）、最大ADC（ADCmax）、最小ADC（ADCmin）和ADC范围（ADCmax-ADCmean）、真扩散系数（D）、伪扩散系数（D）测量扩散系数（D*）、双指数模型的灌注分数（f ）、分布扩散系数（DDC）和拉伸指数模型的扩散异质性指数（α）。收集了 5 年的生存数据。

结果

治疗失败组31例，局部对照组14例。与局部对照组相比，治疗失败组的ADCmean、ADCmax、ADCmin、D、 f显着较低，D* 值较高（ p < 0.05）。当D*为38.85×10 –3 ^mm 2 ^/ s时，D*的AUC最大为0.802，敏感性和特异性分别为77.4%和85.7%。Kaplan-Meier生存分析显示N分期、ADCmean、ADCmax、ADCmin、D、D*、 f、DDC和α值的曲线显着。多变量 Cox 回归分析显示 ADCmean 和 D* 与无进展生存期 (PFS) 独立相关（风险比 [HR] = 0.125，p = 0.001；HR = 1.008，p = 0.002，分别）。