Apparent diffusion coefficients are closely related with high-risk human papilloma virus infection in cervical squamous cell carcinoma patients

The feasibility of a radial turbo-spin-echo T2 mapping for preoperative prediction of the histological grade and lymphovascular space invasion of cervical squamous cell carcinoma

PURPOSE

The study aimed to analyze the feasibility of a radial turbo-spin-echo (TSE) T2 mapping to differentiate the histological grades and lymphovascular space invasion (LVSI) of cervical squamous cell carcinoma (CSCC) in comparison with diffusion-weighted imaging (DWI).

METHODS

A total of 58 patients with CSCC and 40 healthy volunteers underwent T2 mapping and DWI before therapy. The T2 and apparent diffusion coefficient (ADC) values were calculated using different tumor characteristics. The differences, efficacies and correlations between parameters were determined.

RESULTS

The T2 and ADC values were significantly different between CSCC and normal cervical stroma (both p < 0.05). Poorly differentiated (G3) tumor showed lower T2 and ADC values than well differentiated (G1) and moderately differentiated (G2) tumor (all p < 0.05). The T2 values were significantly lower in LVSI-positive CSCC than LVSI-negative CSCC (p < 0.05). No significant difference was found in ADC values for LVSI status (p = 0.561). The area under the ROC (AUC) for T2 and ADC values to distinguish G1/G2 and G3 tumor were 0.741 and 0.763, respectively. The AUC for T2 and ADC values to distinguish LVSI-positive and LVSI-negative CSCC were 0.877 and 0.537, respectively. The T2 and ADC values were negatively correlated with the tumor grades (r = -0.402 and r = -0.339, respectively).

CONCLUSIONS

Radial TSE T2 mapping is feasible for CSCC. Similar to ADC values, quantitative T2 values could serve as a noninvasive biomarker to predict histological grades preoperatively. Moreover, T2 values could determine the presence of LVSI better than ADC values.

Comparison of Imaging Findings between Human Papillomavirus-positive and -Negative Squamous Cell Carcinomas of the Maxillary Sinus

Objectives:

This study aimed to assess the efficacy of imaging findings when differentiating between human papillomavirus (HPV)-positive and -negative squamous cell carcinomas (SCCs) of the maxillary sinus.

Material and Methods:

This study included 37 patients with histopathologically and immunohistochemically confirmed SCCs of the maxillary sinus (three HPV positive and 34 HPV negative). Apparent diffusion coefficients (ADCs), MR signal intensities, CT findings, and maximum standardized uptake (SUVmax) were correlated with the two pathologies.

Results:

The minimum ADC (ADCmin) was significantly lower in HPV-positive SCCs than in HPV-negative SCCs (0.50 ± 0.02 vs. 0.70 ± 0.13 × 10⁻³ mm²/s, P < 0.01). The mean ADC (ADCmean) was not significantly different between HPV-positive SCCs and HPV-negative SCCs (0.84 ± 0.07 vs. 0.97 ± 0.18 ×10⁻³ mm²/s, P = 0.18). The areas under the receiver operating characteristic curves for ADCmin and ADCmean were 0.986 (P < 0.01) and 0.754 (P < 0.05), respectively. The sensitivity and specificity, with a threshold of ADCmin (0.516 × 10⁻³ mm²/s) for a diagnosis of HPV-positive SCCs, were 100% and 96%, respectively. However, no significant differences were observed in MR signal intensities, CT findings, and SUVmax between HPV-positive and HPV-negative SCCs.

Conclusion:

ADCmin is a useful parameter for the differentiation of HPV-positive and HPV-negative SCCs of the maxillary sinus.