Whole-tumour Apparent Diffusion Coefficient (ADC) Histogram Analysis to Identify MYCN-amplification in Neuroblastomas: Preliminary Results

Overview

Journal Eur Radiol

Specialty Radiology

Date 2022 Apr 19

PMID 35437614

Authors

Adarsh Ghosh

Ensar Yekeler

Deepa Dalal

Alexandria Holroyd

Lisa States

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine the role of apparent diffusion coefficient (ADC) histogram analysis in the identification of MYCN-amplification status in neuroblastomas.

Methods: We retrospectively evaluated imaging records from 62 patients with neuroblastomas (median age: 15 months (interquartile range (IQR): 7-24 months); 38 females) who underwent magnetic resonance imaging at our institution before the initiation of any therapy or biopsy. Fourteen patients had MYCN-amplified (MYCNA) neuroblastoma. Histogram parameters of ADC maps from the entire tumour was obtained from the baseline images and the normalised images. The Mann-Whitney U test was used to compare the absolute and normalised histogram parameters amongst neuroblastomas with and without MYCN-amplification. Receiver operating characteristic (ROC) curves and area under the curves (AUC) were generated for the statistically significant histogram parameters. Cut-offs obtained from the ROC curves were evaluated on an external validation set (n-15, MYCNA-6, F-7, age 24 months (10-60)). A logistic regression model was trained to predict MYCNA by combining statistically significant histogram parameters and was evaluated on the validation set.

Results: MYCN-amplified neuroblastomas had statistically significant higher maximum ADC and lower minimum ADC than non-amplified neuroblastomas. They also demonstrated higher entropy, variance, energy, and lower uniformity than non-amplified neoplasms (p > 0.05). Energy, entropy, and maximum ADC had AUC of 0.85, 0.79, and 0.82, respectively.

Conclusions: Whole tumour ADC histogram analysis of neuroblastomas can differentiate between tumours with and without MYCN-amplification. These parameters can help identify areas for targeted biopsies or can be used to predict subtypes of these high-risk tumours before biopsy results are available.

Key Points: • MYCN-amplification significantly affects treatment decisions in neuroblastomas. • MYCN-amplified neuroblastomas had significantly different ADC histogram metrics as compared to tumours without amplification. • ADC histogram metrics can be used to predict MYCN-amplification status based on imaging.

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References

Brodeur G . Neuroblastoma: biological insights into a clinical enigma. Nat Rev Cancer. 2003; 3(3):203-16. DOI: 10.1038/nrc1014. View

Maris J, Weiss M, Guo C, Gerbing R, Stram D, White P . Loss of heterozygosity at 1p36 independently predicts for disease progression but not decreased overall survival probability in neuroblastoma patients: a Children's Cancer Group study. J Clin Oncol. 2000; 18(9):1888-99. DOI: 10.1200/JCO.2000.18.9.1888. View

Bagatell R, Beck-Popovic M, London W, Zhang Y, Pearson A, Matthay K . Significance of MYCN amplification in international neuroblastoma staging system stage 1 and 2 neuroblastoma: a report from the International Neuroblastoma Risk Group database. J Clin Oncol. 2008; 27(3):365-70. PMC: 2651034. DOI: 10.1200/JCO.2008.17.9184. View

Schmidt M, Lal A, Seeger R, Maris J, Shimada H, OLeary M . Favorable prognosis for patients 12 to 18 months of age with stage 4 nonamplified MYCN neuroblastoma: a Children's Cancer Group Study. J Clin Oncol. 2005; 23(27):6474-80. DOI: 10.1200/JCO.2005.05.183. View

Ambros P, Ambros I, Brodeur G, Haber M, Khan J, Nakagawara A . International consensus for neuroblastoma molecular diagnostics: report from the International Neuroblastoma Risk Group (INRG) Biology Committee. Br J Cancer. 2009; 100(9):1471-82. PMC: 2694415. DOI: 10.1038/sj.bjc.6605014. View

Marrano P, Irwin M, Thorner P . Heterogeneity of MYCN amplification in neuroblastoma at diagnosis, treatment, relapse, and metastasis. Genes Chromosomes Cancer. 2016; 56(1):28-41. DOI: 10.1002/gcc.22398. View

Ambros I, Benard J, Boavida M, Bown N, Caron H, Combaret V . Quality assessment of genetic markers used for therapy stratification. J Clin Oncol. 2003; 21(11):2077-84. DOI: 10.1200/JCO.2003.03.025. View

Koh D, Collins D . Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007; 188(6):1622-35. DOI: 10.2214/AJR.06.1403. View

Enkhbaatar N, Inoue S, Yamamuro H, Kawada S, Miyaoka M, Nakamura N . MR Imaging with Apparent Diffusion Coefficient Histogram Analysis: Evaluation of Locally Advanced Rectal Cancer after Chemotherapy and Radiation Therapy. Radiology. 2018; 288(1):129-137. DOI: 10.1148/radiol.2018171804. View

10.

Wang K, Cheng J, Wang Y, Wu G . Renal cell carcinoma: preoperative evaluate the grade of histological malignancy using volumetric histogram analysis derived from magnetic resonance diffusion kurtosis imaging. Quant Imaging Med Surg. 2019; 9(4):671-680. PMC: 6511711. DOI: 10.21037/qims.2019.04.14. View

11.

Zhang Y, Wu C, Wang Q, Zhang J, Wang X, Liu X . Comparison of Utility of Histogram Apparent Diffusion Coefficient and R2* for Differentiation of Low-Grade From High-Grade Clear Cell Renal Cell Carcinoma. AJR Am J Roentgenol. 2015; 205(2):W193-201. DOI: 10.2214/AJR.14.13802. View

12.

Xing P, Chen L, Yang Q, Song T, Ma C, Grimm R . Differentiating prostate cancer from benign prostatic hyperplasia using whole-lesion histogram and texture analysis of diffusion- and T2-weighted imaging. Cancer Imaging. 2021; 21(1):54. PMC: 8477463. DOI: 10.1186/s40644-021-00423-5. View

13.

Umanodan T, Fukukura Y, Kumagae Y, Shindo T, Nakajo M, Takumi K . ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma. J Magn Reson Imaging. 2016; 45(4):1195-1203. DOI: 10.1002/jmri.25452. View

14.

Li D, Cui Y, Hou L, Bian Z, Yang Z, Xu R . Diffusion kurtosis imaging-derived histogram metrics for prediction of resistance to neoadjuvant chemoradiotherapy in rectal adenocarcinoma: Preliminary findings. Eur J Radiol. 2021; 144:109963. DOI: 10.1016/j.ejrad.2021.109963. View

15.

Lasso A, Heffter T, Rankin A, Pinter C, Ungi T, Fichtinger G . PLUS: open-source toolkit for ultrasound-guided intervention systems. IEEE Trans Biomed Eng. 2014; 61(10):2527-37. PMC: 4437531. DOI: 10.1109/TBME.2014.2322864. View

16.

van Griethuysen J, Fedorov A, Parmar C, Hosny A, Aucoin N, Narayan V . Computational Radiomics System to Decode the Radiographic Phenotype. Cancer Res. 2017; 77(21):e104-e107. PMC: 5672828. DOI: 10.1158/0008-5472.CAN-17-0339. View

17.

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

18.

Barrett T, Lawrence E, Priest A, Warren A, Gnanapragasam V, Gallagher F . Repeatability of diffusion-weighted MRI of the prostate using whole lesion ADC values, skew and histogram analysis. Eur J Radiol. 2019; 110:22-29. DOI: 10.1016/j.ejrad.2018.11.014. View

19.

Huo J, Alger J, Kim H, Brown M, Okada K, Pope W . Between-Scanner and Between-Visit Variation in Normal White Matter Apparent Diffusion Coefficient Values in the Setting of a Multi-Center Clinical Trial. Clin Neuroradiol. 2015; 26(4):423-430. DOI: 10.1007/s00062-015-0381-3. View

20.

Ghosh A, Singh T, Singla V, Bagga R, Khandelwal N . Comparison of Absolute Apparent Diffusion Coefficient (ADC) Values in ADC Maps Generated Across Different Postprocessing Software: Reproducibility in Endometrial Carcinoma. AJR Am J Roentgenol. 2017; 209(6):1312-1320. DOI: 10.2214/AJR.17.18002. View