Histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging can predict histopathological findings including proliferation potential, cellularity, and nucleic areas in head and neck squamous cell carcinoma

Our purpose was to analyze possible associations between histogram analysis parameters of dynamic contrast-enhanced magnetic resonance imaging DCE MRI and histopathological findings like proliferation index, cell count and nucleic areas in head and neck squamous cell carcinoma (HNSCC). 30 patients (mean age 57.0 years) with primary HNSCC were included in the study. In every case, histogram analysis parameters of K(trans), V(e), and K(ep) were estimated using a mathlab based software. Tumor proliferation index, cell count, and nucleic areas were estimated on Ki 67 antigen stained specimens. Spearman's non-parametric rank sum correlation coefficients were calculated between DCE and different histopathological parameters. KI 67 correlated with K(trans) min (p = −0.386, P = 0.043) and s K(trans) skewness (p = 0.382, P = 0.045), V(e) min (p = −0.473, P = 0.011), Ve entropy (p = 0.424, P = 0.025), and K(ep) entropy (p = 0.464, P = 0.013). Cell count correlated with K(trans) kurtosis (p = 0.40, P = 0.034), V(e) entropy (p = 0.475, P = 0.011). Total nucleic area correlated with V(e) max (p = 0.386, P = 0.042) and V(e) entropy (p = 0.411, P = 0.030). In G1/2 tumors, only K(trans) entropy correlated well with total (P =0.78, P =0.013) and average nucleic areas (p = 0.655, P = 0.006). In G3 tumors, KI 67 correlated with Ve min (p = −0.552, P = 0.022) and V(e) entropy (p = 0.524, P = 0.031). Ve max correlated with total nucleic area (p = 0.483, P = 0.049). Kep max correlated with total area (p = −0.51, P = 0.037), and K(ep) entropy with KI 67 (p = 0.567, P = 0.018). We concluded that histogram-based parameters skewness, kurtosis and entropy of K(trans), V(e), and K(ep) can be used as markers for proliferation activity, cellularity and nucleic content in HNSCC. Tumor grading influences significantly associations between perfusion and histopathological parameters.