Synopsis

Keywords: Cancer, Cancer, esophageal squamous cell carcinoma

A total of 50 patients with locally advanced ESCC were prospectively enrolled in this study. Diffusion Weighted Imaging (DWI) with multiple high b-values was performed before surgery, and a new set of parameters (D, β and m) from a fractional order calculus (FROC) diffusion model were acquired. The grade of differentiation about ESCC was assessed. We found that β and D value exhibited non-significant difference, and m value showed a significant difference between different grades ESCC (P =0.029).

Introduction

To explore the value of a new set of parameters (D, β and m) from a fractional order calculus (FROC) diffusion model in predicting the grade of differentiation in esophageal squamous cell carcinoma (ESCC)[1, 2].

Methods

This study was approved by the Hospital Ethics Committee, and the written informed consent form was waived. A total of 50 patients with ESCC were prospectively enrolled from October 2020 to September 2021, and the grad of differentiation was confirmed by postoperative pathology. MR scanning was performed within 1 week before surgery on a 3T MR scanner(MAGNETOM Skyra, Siemens Healthineers, Erlangen, Germany), DWI sequence was performed with 12 b-values(b, 0, 50, 100, 150, 200, 400, 500, 600, 800, 1000, 1500, 2000s/mm2). DWI parameters map from fractional order calculus (FROC) diffusion model were reconstructed calculated using a unified in-house developed software called BoDiLab, which is based on Python 3.7. The parameters included apparent diffusion coefficient (D), fractional order parameter b (which correlates with tissue heterogeneity), and a microstructural quantity m [3]. The degree of differentiation of low-, middle- and high-grade were assessed, and these values were compared using the one-way ANOVA between the low, middle and high-grade tumor groups, respectively.

Results

Twenty-two patients were identified as low grade, 23 as middle grade, and 5 as high grade by pathology. D, β and m of different grade groups were shown in Table 1, and only m showed significant difference between different grade groups (P =0.029). Patients were stratified into high group and middle & low group, ROCs of D, β and m for high group and middle & low group were shown in Table 2. m (0.756) had a higher AUC than both D (0.627) and β (0.533).

Conclusion

Among the new set of parameters in high b-value DWI, m may be used to predict the grade of differentiation in ESCC patients.

Discussion

Our study found a new set of parameters from a fractional order calculus (FROC) diffusion model may be used as an effective functional imaging technique to predict the grade of differentiation in ESCC patients, and the m value showed a significant difference between different grades ESCC (P=0.029). The m value has been suggested as a measure of diffusion mean free length, but its biologic interpretation remains intriguing[3].

Acknowledgements

No acknowledgement found.