THE RELATIONSHIP BETWEEN TUMOR AND LYMPHADENOPATHY CT HISTOGRAM PARAMETERS AND TUMOR STAGE AND HPV STATUS IN HEAD AND NECK SQUAMOUS CELL CARCINOMA
Journal Title: Kocatepe Medical Journal - Year 2023, Vol 24, Issue 1
Abstract
OBJECTIVE: This study aimed to evaluate the association between computed tomography (CT) histogram parameters of the tumor and lymphadenopathy and tumor stage and Human papillomavirus (HPV) status in head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS: Data archive and CT images from the ‘HNSCC’ study, which are publicly available on ‘The Cancer Imaging Archive’ website, were used in this study. Patients who had a pretreatment contrast-enhanced neck CT examination with a slice thickness of 1.3 mm and whose HPV status were known were included in the study. Histogram analysis was performed on 215 tumors and 197 lymphadenopathies. Tumor and lymphadenopathy boundaries, including cystic and necrotic areas, were manually drawn from a single axial CT slice where the lesion size was the largest. Then, histogram parameters (mean, variance, skewness, kurtosis, 1st percentile (P), 10th P, 50th P, 90th P, 99th P) were calculated from the corresponding areas. Histogram parameters were compared with T (tumor), N (lymph node), and TNM (tumor-lymph node-metastasis) stage and HPV status of tumors. RESULTS: 178 males and 37 females were included in this study (median age 57 years). There were significant differences in mean, variance, 10th P, 50th P, 90th P, and 99th P values of the tumor and skewness value of lymphadenopathy between T stages (p: 0.05, 0.038, 0.032, 0.047, 0.046, 0.022 ve 0.008, respectively). We found that the 10th P value of the tumor was significantly higher in the N0 stage than in the N3 stage (p:0.028). There were no significant differences in histogram parameters between TNM stages (p:0.073-0.792). Variance and 50th P values of the tumor were significantly lower in HPV positive tumors than in HPV negatives (p: 0.035 ve 0.048, respectively). CONCLUSIONS: CT histogram parameters showed significant differences between T stage, N stage, and HPV status in HNSCC. Variance value reflecting the heterogeneity was found higher in HPV negative tumors and high T stages.
Authors and Affiliations
Yasin SARIKAYA1, Sevtap ARSLAN2
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