Magnetic resonance imaging (MRI) is an indispensable, routine technique that provides morphological and functional imaging sequences. MRI can potentially capture tumor biology and allow for longitudinal evaluation of head and neck squamous cell carcinoma (HNSCC). This systematic review and meta-analysis evaluates the ability of MRI to predict tumor biology in primary HNSCC. Studies were screened, selected, and assessed for quality using appropriate tools according to the PRISMA criteria. Fifty-eight articles were analyzed, examining the relationship between (functional) MRI parameters and biological features and genetics. Most studies focused on HPV status associations, revealing that HPV-positive tumors consistently exhibited lowerADCmean(SMD: 0.82;p< 0.001) andADCminimum(SMD: 0.56;p< 0.001) values. On average, lowerADCmeanvalues are associated with high Ki-67 levels, linking this diffusion restriction to high cellularity. Several perfusion parameters of the vascular compartment were significantly associated with HIF-1α. Analysis of other biological factors (VEGF, EGFR, tumor cell count, p53, and MVD) yielded inconclusive results. Larger datasets with homogenous acquisition are required to develop and test radiomic-based prediction models capable of capturing different aspects of the underlying tumor biology. Overall, our study shows that rapid and non-invasive characterization of tumor biology via MRI is feasible and could enhance clinical outcome predictions and personalized patient management for HNSCC.
磁共振成像（MRI）是一种不可或缺的常规技术，可提供形态学和功能学成像序列。MRI能够捕捉肿瘤生物学特征，并实现对头颈部鳞状细胞癌（HNSCC）的纵向评估。本系统性综述与荟萃分析评估了MRI预测原发性HNSCC肿瘤生物学特征的能力。研究根据PRISMA标准，采用适当工具对文献进行筛选、选择及质量评估。共纳入58篇文献，分析了（功能）MRI参数与生物学特征及遗传学指标之间的关联。多数研究聚焦于人乳头瘤病毒（HPV）状态相关性，结果显示HPV阳性肿瘤始终表现出更低的ADC均值（标准化均数差：0.82；p<0.001）和ADC最小值（标准化均数差：0.56；p<0.001）。总体而言，较低的ADC均值与高Ki-67水平相关，表明这种扩散受限与高细胞密度存在关联。血管腔室的多个灌注参数与HIF-1α呈显著相关。对其他生物学因子（VEGF、EGFR、肿瘤细胞计数、p53及MVD）的分析未能获得确定性结论。需要采用标准化采集方式的更大规模数据集来开发和测试基于影像组学的预测模型，以捕捉肿瘤潜在生物学特征的不同维度。总体而言，本研究证实通过MRI实现快速、无创的肿瘤生物学表征具有可行性，有望提升HNSCC临床预后预测能力及个体化诊疗水平。
肿瘤(癌症)患者之家