Correlation between Histogram Analysis Parameters Derived from DCE-MRI and the Expression of PD-L1 in Esophageal Squamous Cell Carcinoma. A Preliminary Study

Abstract

Purpose: To investigate the correlation between the histogram parameters (Ktrans, Kep, Ve) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and programmed death-ligand 1 (PD-L1) expression in esophageal squamous cell carcinoma (ESCC).

Methods: Overall, 23 ESCC patients without prior surgery underwent DCE-MRI before treatment. Histogram parameters of DCE-MRI were extracted, and PD-L1 expression in lesions was detected by immunohistochemistry. PD-L1 expression was evaluated using three scoring methods: Tumor Proportion Score (TPS), Combined Positive Score (CPS), and Immune Cell Score (ICS).

Results: CPS correlated with the kurtosis and skewness coefficients derived from the Ktrans (r = -0.416, p = 0.048 and r = -0.507, p = 0.013). Additionally, CPS correlated with the P90 and kurtosis coefficients derived from the Kep (r = 0.424, p = 0.044 and r = 0.422, p = 0.044). ICS correlated with the mean value derived from the Ktrans (r = 0.431, p = 0.040). No association was observed between DCE-MRI parameters and TPS.

Conclusion: Ktrans and Kep related histogram analysis parameters derived from DCE-MRI showed correlation with PD-L1 expression in immune cells of ESCC. Therefore, histogram analysis parameters derived from DCE-MRI may serve as an effective imaging biomarker for pre-therapeutic assessment of immunotherapy eligibility in patients with ESCC.