Whole-tumour histogram analysis of pharmacokinetic parameters from dynamic contrast-enhanced MRI in resectable oesophageal squamous cell carcinoma can predict T-stage and regional lymph node metastasis.

Objective: To identify whether whole-tumour histogram analysis of pharmacokinetic parameters from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could predict T-stage and regional lymph node metastasis (LNM) of resectable oesophageal squamous cell carcinoma (SCC).

Materials And Methods: Forty-two consecutive patients with confirmed oesophageal SCC underwent thoracic DCE-MRI. Histogram metrics (median, mean, standard deviation [SD], skewness, kurtosis and entropy) of whole-tumour pharmacokinetic parameters including endothelial transfer constant (K), reflux rate (K) and fractional extravascular extracellular space volume (V) were generated by the Omni-Kinetics software. Histogram datasets were interpreted using the Mann-Whitney U test and receiver operating characteristic (ROC) statistical analyses.

Results: The Mann-Whitney U tests revealed that the median, mean and SD of K, the SD and entropy of K, and the median, mean and entropy of V of T1-2 stage oesophageal SCC were lower when compared with T3 stage (all Ps < 0.05); and the ROC analysis showed that the entropy of V could reliably distinguish T1-2 stage from T3 stage with an area under ROC (AUC) of 0.773. The Mann-Whitney U tests illustrated that the entropy of K, and the median, mean, SD and entropy of K were higher while the skewness of K was lower in tumours with LNM than without LNM (all Ps < 0.05); and the ROC analysis demonstrated that the SD of K could best identify tumours with LNM with an AUC of 0.702.

Conclusion: Whole-tumour histogram analysis of pharmacokinetic parameters of oesophageal SCC on DCE-MRI could be used to predict T-stage and regional LNM.