{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:04:16Z","timestamp":1775801056822,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n In oral tongue squamous cell carcinoma (OTSCC), cervical lymph node metastasis (CLNM) reduces predicted survival by 50%. However, MRI sensitivity for occult nodal disease is only 35.7%, reflecting limited microstructural specificity.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To investigate whether diffusion\u2010relaxation correlated spectroscopic imaging (DR\u2010CSI) metrics with peritumoral extensions contribute toward the prediction of CLNM in OTSCC.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n 99 patients (33 female and 66 male) with pathologically confirmed OTSCC.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n 3T; a spin\u2010echo echo\u2010planar DR\u2010CSI with 35 contrasts.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n Tumor\u2010stroma ratio (TSR), density of tumor\u2010infiltrating lymphocytes (TILs), perineural invasion (PNI) and differentiation status were determined from histology. Tumor greatest diameter and depth of invasion (DOI) were evaluated from MRI. Apparent diffusion coefficient (ADC) maps and\n T<\/jats:italic>\n 2<\/jats:sub>\n maps were derived from DR\u2010CSI data. Five DR\u2010CSI compartmental metrics in intratumoral and peritumoral regions,\n V<\/jats:italic>\n A<\/jats:sub>\n \u2013\n V<\/jats:italic>\n E<\/jats:sub>\n , were calculated.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Mann\u2013Whitney U\u2010test, Chi\u2010square test, or Spearman correlation analysis. Multivariable logistic regression and receiver operating characteristic (ROC) analysis for diagnostic performance. Significance criteria:\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 51 patients were CLNM negative. Intratumoral\n V<\/jats:italic>\n A<\/jats:sub>\n in the CLNM\u2010positive group (34.80%\u2009\u00b1\u200918.51%) was significantly lower than that in the CLNM\u2010negative group (47.86%\u2009\u00b1\u200923.37%), while\n V<\/jats:italic>\n B<\/jats:sub>\n (25.07%\u2009\u00b1\u200912.49%) and\n V<\/jats:italic>\n D<\/jats:sub>\n (22.12%\u2009\u00b1\u200911.46%) in the CLNM\u2010positive group were significantly higher than those in the CLNM\u2010negative group. ADC and\n T<\/jats:italic>\n 2<\/jats:sub>\n showed no significant separation (\n p<\/jats:italic>\n \u2009=\u20090.084, 0.493, respectively). A multivariable logistic model comprising the significant intratumoral and peritumoral DR\u2010CSI metrics (\n V<\/jats:italic>\n A<\/jats:sub>\n ,\n V<\/jats:italic>\n B<\/jats:sub>\n , and\n V<\/jats:italic>\n D<\/jats:sub>\n ) together with the morphologic variables (tumor greatest diameter and DOI) achieved an area under curve (AUC) value of 0.792 for CLNM classification, representing a non\u2010significant improvement over the morphologic variables model alone (AUC 0.709,\n p<\/jats:italic>\n \u2009=\u20090.069).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n The intratumoral and peritumoral DR\u2010CSI metrics, combined with morphologic variables, improved preoperative discrimination of nodal status in OTSCC in this single center cohort, though external validation is warranted.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 2.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70273","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T02:55:03Z","timestamp":1771815303000},"page":"1323-1335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diffusion Relaxation\u2014Correlated Spectroscopic\n MR<\/scp>\n Imaging for In\u00a0Vivo Tumor Heterogeneity and Lymph Node Metastasis Prediction in Oral Tongue Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"63","author":[{"given":"Dongmei","family":"Wu","sequence":"first","affiliation":[{"name":"Shanghai Key Laboratory of Magnetic Resonance, Institute of Magnetic Resonance and Molecular Imaging in Medicine, School of Physics East China Normal University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Ninth People's Hospital Shanghai Jiao Tong 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