Diagnostic value of tumor blood flow and its histogram analysis obtained with pCASL to differentiate sinonasal malignant lymphoma from squamous cell carcinoma.
OBJECTIVE
To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudo-continuous arterial spin labeling (pCASL) for the differentiation of squamous cell carcinoma (SCC) and malignant lymphoma (ML) in the nasal or sinonasal cavity.


METHODS
Thirty-three patients with SCC and 6 patients with ML in the nasal or sinonasal cavity were retrospectively analyzed. Quantitative TBF values were obtained using whole-tumor region of interest (ROI) from pCASL data. The histogram analysis of TBF values within the tumor ROI was also performed by calculating the coefficient of variation (CV), kurtosis, and skewness. The mean TBF value, histogram CV, kurtosis and skewness of the patients with SCC were compared with those of the ML patients. The diagnostic accuracy to differentiate SCC from ML was also calculated by receiver operating characteristic (ROC) curve analysis. In addition, multiple logistic regression models were also performed to determine their independent predictive value, and diagnostic accuracy with the combined use of these parameters.


RESULTS
Between the SCC and ML groups, significant differences were observed in mean TBF, CV, and kurtosis, but not in skewness. In ROC curve analysis, the diagnostic accuracy values for the differentiation of SCC from ML in mean TBF, CV, and kurtosis were all 0.87, respectively. Multiple logistic regression models revealed TBF and CV were respectively independent predictive value. With the combination of these parameters, the diagnostic accuracy was elevated to 0.97.


CONCLUSIONS
The TBF value and its histogram analysis obtained with pCASL can help differentiate SCC and ML.
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan. Electronic address: Noriyuki.Fujima@mb9.seikyou.ne.jp.
Noriyuki
N
Fujima
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Hiroyuki
H
Kameda
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Akiko
A
Tsukahara
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Daisuke
D
Yoshida
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Tomohiro
T
Sakashita
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Akihiro
A
Homma
Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan; The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo, Japan.
Khin Khin
KK
Tha
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Kohsuke
K
Kudo
Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan; The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo, Japan.
Hiroki
H
Shirato
D000368:Aged; D019540:Area Under Curve; D001783:Blood Flow Velocity; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Malignant lymphoma; Pseudo-continuous arterial spin labeling; Squamous cell carcinoma; Tumor blood flow