Can Imaging Parameters Provide Information Regarding Histopathology in Head and Neck Squamous Cell Carcinoma? A Meta-Analysis

OBJECT: Our purpose was to provide data regarding relationships between different imaging and histopathological parameters in HNSCC. METHODS: MEDLINE library was screened for associations between different imaging parameters and histopathological features in HNSCC up to December 2017. Only papers containing correlation coefficients between different imaging parameters and histopathological findings were acquired for the analysis. RESULTS: Associations between 18F-FDG positron emission tomography (PET) and KI 67 were reported in 8 studies (236 patients). The pooled correlation coefficient was 0.20 (95% CI = [−0.04; 0.44]). Furthermore, in 4 studies (64 patients), associations between 18F-fluorothymidine PET and KI 67 were analyzed. The pooled correlation coefficient between SUVmax and KI 67 was 0.28 (95% CI = [−0.06; 0.94]). In 2 studies (23 patients), relationships between KI 67 and dynamic contrast-enhanced magnetic resonance imaging were reported. The pooled correlation coefficient between Ktrans and KI 67 was −0.68 (95% CI = [−0.91; −0.44]). Two studies (31 patients) investigated correlation between apparent diffusion coefficient (ADC) and KI 67. The pooled correlation coefficient was −0.61 (95% CI = [−0.84; −0.38]). In 2 studies (117 patients), relationships between 18F-FDG PET and p53 were analyzed. The pooled correlation coefficient was 0.0 (95% CI = [−0.87; 0.88]). There were 3 studies (48 patients) that investigated associations between ADC and tumor cell count in HNSCC. The pooled correlation coefficient was −0.53 (95% CI = [−0.74; −0.32]). Associations between 18F-FDG PET and HIF-1α were investigated in 3 studies (72 patients). The pooled correlation coefficient was 0.44 (95% CI = [−0.20; 1.08]). CONCLUSIONS: ADC may predict cell count and proliferation activity, and SUVmax may predict expression of HIF-1α in HNSCC. SUVmax cannot be used as surrogate marker for expression of KI 67 and p53.