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Histogram Analysis Parameters Derived from Conventional T1- and T2-Weighted Images Can Predict Different Histopathological Features Including Expression of Ki67, EGFR, VEGF, HIF-1α, and p53 and Cell Count in Head and Neck Squamous Cell Carcinoma.

PURPOSE: To analyze associations between histogram analysis parameters derived from conventional magnetic resonance imaging (MRI) and different histopathological features in head and neck squamous cell carcinoma (HNSCC).

PROCEDURES: Thirty-four patients with histologically proven primary HNSCC were prospectively acquired. Histogram analysis was derived from pre-contrast T1-weighted (T1w) and T2-weighted (T2w) images. In all cases, expression of HIF-1α, VEGF, EGFR, p53, Ki67, and p16 as well as tumor cell count was analyzed.

RESULTS: In the overall sample, inverse correlation between entropy derived from T1w images and p53 expression (p = - 0.458, P = 0.01) was found. Furthermore, p10 derived from T1w images correlated with VEGF expression (p = 0.371, P = 0.04). In the p16-positive tumors, VEGF expression correlated with several parameters derived from T1w images: mean (p = 0.481, P = 0.032), p10 (p = 0.489, P = 0.029), p25 (p = 0.475, P = 0.034), median (p = 0.468, P = 0.037), and mode (p = 0.492, P = 0.028). Several T2w parameters were associated with p53 expression: mean (p = 0.569, P = 0.007), p25 (p = 0.508, P = 0.019), p75 (p = 0.479, P = 0.028), median (p = 0.555, P = 0.009), and mode (p = 0.468, P = 0.033). Kurtosis derived from T2w images correlated with cell count (p = 0.534, P = 0.013). In p16-negative carcinomas, T2w parameters correlated with p53 expression: max (p = 0.736, P = 0.015), p90 (p = 0.687, P = 0.028), and standard deviation (p = 0.760, P = 0.011). T2w p10 (p = - 0.709, P = 0.022) and T2w p25 (p = - 0.733, P = 0.016) correlated also with HIF-1α expression.

CONCLUSIONS: Multiple associations between histogram parameters derived from T1w and T2w images and clinically relevant histopathological features were found in HNSCC. Therefore, imaging parameters can be also used as surrogate markers for tumor cellularity, proliferation, and vascularization in HNSCC. The identified correlations differed significantly between p16-positive and p16-negative cancers.

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