Whole-tumor ADC Histogram Analysis in evaluating Tongue Squamous Cell Carcinoma heterogeneity and predicting Cervical Lymph Node Metastases

Tumor heterogeneity occurred frequently in patients with SCC and associated with poor prognosis. Compared to clinic TNM stage or the histological grade, the histological heterogeneity has not been well addressed yet. Our results clearly demonstrated that higher incidence of CNM was observed in histological hetero-group than that in homo-group. whole-lesion ADC histogram metrics presented lower values in hetero-group and in CNM+ group. ADC75th and kurtosis were two independent prognostic factors for evaluating the CNM status. Whole-tumor ADC histogram offered an approach for detecting intra-tumoral heterogeneity and predicting cervical lymph node metastases status.