The clinical value of quantitative parameters derived from ASL and IVIM for staging nasopharyngeal carcinoma

LI Xiaoqin; SHEN Hesong; ZHANG Jing; LIU Meiling; WANG Xing; YUAN Xiaoxi; ZHANG Jiuquan

doi:10.19732/j.cnki.2096-6210.2022.04.008

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The clinical value of quantitative parameters derived from ASL and IVIM for staging nasopharyngeal carcinoma

更新时间：2025-12-15

- The clinical value of quantitative parameters derived from ASL and IVIM for staging nasopharyngeal carcinoma
- Vol. 31, Issue 4, Pages: 393-401(2022)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2022.04.008
  CLC：
- Published Online：28 August 2022，
  
  Published：28 August 2022
- 稿件说明：
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李小芹,沈合松,张菁,等. IVIM和ASL定量参数在鼻咽癌分期中的临床价值[J]. 肿瘤影像学, 2022, 31(4): 393-401 https://doi.

org/10.19732/j.cnki.2096-6210.2022.04.008
李小芹,沈合松,张菁,等. IVIM和ASL定量参数在鼻咽癌分期中的临床价值[J]. 肿瘤影像学, 2022, 31(4): 393-401 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.04.008.

org/10.19732/j.cnki.2096-6210.2022.04.008 DOI：

摘要

目的：

比较体素内不相干运动（intravoxel incoherent motion，IVIM）与动脉自旋标记（arterial spin labeling，ASL）的定量参数在鼻咽癌分期中的临床价值，并探讨这些参数的相关性。

方法：

对56例经病理学检查证实的鼻咽癌患者进行IVIM和ASL成像，并对患者进行T、N分期和临床分期，分为低分期组和高分期组。计算参数肿瘤血流量（tumor blood flow，TBF）、慢弥散系数（slow ADC，

）、快弥散系数（fast ADC，

）、灌注分数（perfusion fraction，

）的均值、最小值和最大值。用组内相关系数（intraclass correlation coefficient，ICC）和Bland-Altman图探讨各参数可靠性。应用受试者工作特征（receiver operating characteristic，ROC）曲线判断各参数的诊断性能。采用Spearman分析ASL与IVIM参数的相关性。

结果：

在T分期和临床分期中，低分期组的TBF平均值（TBF mean ）和f平均值（

mean

）显著高于高T分期和高临床分期组。在区分高低T分期鼻咽癌时，TBF

mean

的ROC曲线的曲线下面积（area under curve，AUC）高于f mean （0.888

0.789，

=0.022）。在区分高低临床分期鼻咽癌时，TBF

mean

的AUC高于

mean

（0.838

0.741，

=0.025）。TBF

mean

与

mean

呈中度相关（

=0.632，

＜0.001）。

结论：

ASL与IVIM可以很好地评估鼻咽癌的血流灌注信息，有利于预测鼻咽癌患者治疗前的临床分期。与IVIM的

mean

相比，ASL的TBF

mean

在鉴别鼻咽癌高低T分期、临床分期方面表现更好，且ASL与IVIM的灌注参数呈中度正相关。

Abstract

Objective:

To compare the clinical value of quantitative parameters derived from intravoxel incoherent motion (IVIM) and arterial spin labeling (ASL) for staging nasopharyngeal carcinoma (NPC) and determine the correlation of these quantitative parameters.

Methods:

Fifty-six consecutive patients with pathological confirmed NPC were performed both ASL and IVIM imaging and were assigned into low- or high-tumor stage groups. The mean

minimum and maximum values of four parameters ［TBF

slow ADC (

)、fast ADC (

)

perfusion fraction (

)］ were calculated. The reliability was estimated with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Receiver operating characteristic (ROC) curve was applied to determine diagnostic performance. Spearman analysis was used to analyze the correlation between ASL and IVIM parameters.

Results:

TBF

mean

and

mean

in the low T-stage and clinical-stage groups were significantly higher than those in the high T-stage and clinical-stage groups. For differentiating low from high T-stage NPCs

TBF

mean

showed higher AUC compared with

mean

(0.888

0.789

=0.022). For differentiating low from high clinical-stage NPCs

TBF

mean

showed higher AUC than

mean

(0.838

0.741

=0.025). TBF

mean

showed moderate correlation with

mean

(

=0.632

＜0.001).

Conclusion:

Compared with

mean

derived from IVIM

TBF

mean

derived from ASL achieved better performance for differentiating low T-stage and clinical-stage from high T-stage and clinical-stage in NPC. These ASL and IVIM perfusion parameters were moderately positively correlated.

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