Background:This study aimed at evaluating apparent diffusion coefficient (ADC) values of nasopharyngeal carcinoma (NPC) in the pre-treatment stages of NPC for establishing comparative quantitative parameters between children and adolescents compared to adults.Methods:A retrospective multicentric imaging study was conducted in three medical centers by collecting patient data over a 5-year timeframe. Patients were included in the study based on the following criteria: histopathologically proven carcinoma of the nasopharynx with all available medical records. The total sample included 20 patients (6 pediatric patients and 14 adults). A quantitative analysis of the ADC maps was performed. Two radiologists manually drew the region of interest (ROI) on ADC maps using the whole tumor on all magnetic resonance imaging (MRI) slices. The mean ADC was extracted for each patient and each radiologist’s evaluation. Differences in ADC values between pediatric and adult patients were evaluated using an independent samplest-test, with normality and variance assumptions tested via the Shapiro–Wilk and Levene’s tests, respectively.p-values less than 0.05 were considered statistically significant.Results:The mean ADC values extracted from the initial pre-treatment diffusion-weighted imaging (DWI) data from magnetic resonance imaging (MRI) in children were 712.22 × 10−6mm2/s, compared to adults in whom the mean ADC values were 877.34 × 10−6mm2/s. We found a statistically significant difference between the mean ADC values of pediatric patients and adult patients, t (17.44) = −3.15,p= 0.006, with the mean ADC values of pediatric patients (M = 712.22, standard deviation [SD] = 57.03) being lower, on average, than the mean ADC values of adult patients (M = 877.34, SD = 175.25).Conclusions:Our results showed significantly lower ADC values in pediatric patients than in adults, independent of tumor T-stage. Additionally, early-stage tumors, particularly in children, tended to exhibit even lower ADC values, suggesting potential biological distinctions across age groups.
背景：本研究旨在评估鼻咽癌（NPC）治疗前阶段的表观扩散系数（ADC）值，以建立儿童及青少年与成人之间的定量比较参数。 方法：本研究为一项回顾性多中心影像学研究，在三个医疗中心收集了五年时间范围内的患者数据。纳入标准为经组织病理学证实为鼻咽癌且具备完整医疗记录的患者。样本总量为20例（6例儿童患者和14例成人患者）。对ADC图进行定量分析，由两名放射科医师在所有磁共振成像（MRI）序列的肿瘤整体区域手动勾画感兴趣区（ROI）。提取每位患者及每位医师评估的平均ADC值。采用独立样本t检验比较儿童与成人患者的ADC值差异，并分别通过Shapiro-Wilk检验和Levene检验验证数据正态性及方差齐性假设，p值小于0.05视为具有统计学意义。 结果：儿童组治疗前磁共振扩散加权成像（DWI）数据的平均ADC值为712.22 × 10⁻⁶ mm²/s，成人组为877.34 × 10⁻⁶ mm²/s。统计分析显示儿童与成人患者的平均ADC值存在显著差异（t(17.44) = -3.15, p = 0.006），儿童患者的平均ADC值（M = 712.22，标准差[SD] = 57.03）显著低于成人患者（M = 877.34，SD = 175.25）。 结论：研究结果表明，儿童鼻咽癌患者的ADC值显著低于成人，且该差异与肿瘤T分期无关。此外，早期肿瘤（尤其在儿童中）往往表现出更低的ADC值，提示不同年龄组间可能存在潜在的生物学差异。
Pediatric Versus Adult Nasopharyngeal Cancer in Diffusion-Weighted Magnetic Resonance Imaging
肿瘤(癌症)患者之家