Histogram analysis of apparent diffusion coefficient maps in the prognosis of patients with locally advanced head and neck squamous cell carcinoma: Comparison of different region of interest selection methods.

OBJECTIVE: To investigate the influence of different region of interest (ROI) selection methods on the histogram analysis of apparent diffusion coefficient (ADC) maps and to compare their performance in predicting overall survival (OS) in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: A total of 73 patients with locally advanced HNSCC who underwent pretreatment diffusion-weighted magnetic resonance imaging were included. Based on the largest slice ROI (ROILS) and whole tumor ROI (ROIWT), ADC histogram parameters including mean ADC (ADCmean); median ADC (ADCmedian); 10th, 25th, 75th, and 90th percentiles of ADC values (ADC10, ADC25, ADC75, and ADC90); kurtosis; and skewness were obtained. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate measurement reproducibility. The association of ADC histogram parameters and clinicopathological factors with OS was analyzed using log-rank tests and Cox regression. RESULTS: The measurements of ADC histogram parameters based on ROIWT showed better reproducibility than ROILS (ICCs for ROIWT: 0.772-0.961; ICCs for ROILS: 0.511-0.851). The higher ADC values (ADCmean, ADCmedian, ADC10, and ADC25 based on both ROIs; ADC75 based on ROILS) and lower kurtosis based on ROILS were significantly associated with worse OS of patients with locally advanced HNSCC (all P < 0.05). In the multivariate Cox analysis, ADC10 measured with ROIWT (P = 0.019, hazard ratio = 2.63, 95% confidence interval 1.17-5.90) was an independent prognostic factor after adjusting for clinicopathological factors. CONCLUSIONS: ROI selection methods could influence ADC histogram analysis. ADC10 based on ROIWT had the best independent prognostic value for patients with locally advanced HNSCC.

Radiologic features of primary intracranial ectopic germinomas: Case reports and literature review.

RATIONALE: Germinomas are sensitive to radiation therapy and chemotherapy; therefore, correct imaging diagnosis is crucial for them. However, the imaging findings of germinomas originating from off-midline regions displayed different patterns from those originating from midline areas. PATIENT CONCERNS: The objective of this study is to describe the radiologic features of primary ectopic germinoma. We reviewed the MR and CT findings of 12 patients with histologically proven off-midline ectopic germinomas with off-midline locations. INTERVENTIONS: All of these patients underwent conventional MR images and 3 of them underwent diffusion images. Additional CT images were available in 3 patients. Analysis was focused on the shape and entity of tumors in images, signs of hemiatrophy, and the involvement of fibers in diffusion images. OUTCOMES: Well-defined (8/12) and ill-defined margin masses (4/12) were identified according to the shape of the mass. Multicystic masses were seen in 11 of the 12 patients. The solid component of the tumors had a high density (3/3) with calcifications (2/3) on CT images, iso- to hypointensity in T2WI (11/12) and restricted diffusion on apparent diffusion coefficient (ADC) maps (3/3). Hemiatrophy was observed in 5 cases and progressive hemiatrophy was observed in 1 case. Other signs included mild peritumoral edema (10/12), and hydrocephalus (7/12). Additionally, infiltration of the corticospinal tract (CST) was identified on diffusion tensor imaging (DTI) (2/2). LESSONS: The results indicate that multicysitic entities and hypointensities in solid components on T2WI and hemiatrophy are the imaging features of ectopic germinomas. DTI has potential for assessing CST involvement.

Increased interhemispheric functional connectivity in college students with non-clinical depressive symptoms in resting state.

The underlying neural basis of non-clinical depressive symptoms (nCDSs) remains unclear. Interhemispheric functional connectivity has been suggested as one of the most robust characteristics of brain's intrinsic functional architecture. Here, we investigated the functional connectivity between homotopic points in the brain using the voxel-mirrored homotopic connectivity (VMHC) approach. We performed VMHC analysis on resting-state functional magnetic resonance imaging (rs-fMRI) data from 17 individuals with nCDSs and 20 healthy controls (HCs) who were enrolled from a sample of 1105 college students. We found increased VMHCs in the bilateral posterior cerebellum and fusiform gyrus in nCDSs subjects compared with HCs. Furthermore, receiver operating characteristic (ROC) curves indicated that VMHC values in the posterior cerebellum lobes could use to differente nCDSs from HCs [area under the curve (AUC), 0.756; p<0.01]. We suggest increased VMHCs indicate a possible compensatory mechanism involved in the pathophysiology of nCDSs. VMHC values of the posterior cerebellum lobes might serve as a reliable biomarker for identifying nCDSs.