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<meta name="DC.Title" content="Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5370" />
<meta name="DC.Date" content="2017-09-21" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 American Society of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Head and neck squamous cell carcinoma associated with human papillomavirus infection represents a distinct tumor entity. We hypothesized that diffusion phenotypes based on the histogram analysis of ADC values reflect distinct degrees of tumor heterogeneity in human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas.

MATERIALS AND METHODS: One hundred five consecutive patients (mean age, 64 years; range, 45–87 years) with primary oropharyngeal ( n = 52) and oral cavity ( n = 53) head and neck squamous cell carcinoma underwent MR imaging with anatomic and diffusion-weighted sequences ( b = 0, b = 1000 s/mm2, monoexponential ADC calculation). The collected tumor voxels from the contoured ROIs provided histograms from which position, dispersion, and form parameters were computed. Histogram data were correlated with histopathology, p16-immunohistochemistry, and polymerase chain reaction for human papillomavirus DNA.

RESULTS: There were 21 human papillomavirus–positive and 84 human papillomavirus–negative head and neck squamous cell carcinomas. At histopathology, human papillomavirus–positive cancers were more often nonkeratinizing (13/21, 62%) than human papillomavirus–negative cancers (19/84, 23%; P = .001), and their mitotic index was higher (71% versus 49%; P = .005). ROI-based mean and median ADCs were significantly lower in human papillomavirus–positive (1014 ± 178 × 10−6 mm2/s and 970 ± 187 × 10−6 mm2/s, respectively) than in human papillomavirus–negative tumors (1184 ± 168 × 10−6 mm2/s and 1161 ± 175 × 10−6 mm2/s, respectively; P &lt; .001), whereas excess kurtosis and skewness were significantly higher in human papillomavirus–positive (1.934 ± 1.386 and 0.923 ± 0.510, respectively) than in human papillomavirus–negative tumors (0.643 ± 0.982 and 0.399 ± 0.516, respectively; P &lt; .001). Human papillomavirus–negative head and neck squamous cell carcinoma had symmetric normally distributed ADC histograms, which corresponded histologically to heterogeneous tumors with variable cellularity, high stromal component, keratin pearls, and necrosis. Human papillomavirus–positive head and neck squamous cell carcinomas had leptokurtic skewed right histograms, which corresponded to homogeneous tumors with back-to-back densely packed cells, scant stromal component, and scattered comedonecrosis.

CONCLUSIONS: Diffusion phenotypes of human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas show significant differences, which reflect their distinct degree of tumor heterogeneity.

### Abbreviations

HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
HPV−
:   human papillomavirus–negative
HPV+
:   human papillomavirus–positive" />
<meta name="DC.Contributor" content="T. de Perrot" />
<meta name="DC.Contributor" content="V. Lenoir" />
<meta name="DC.Contributor" content="M. Domingo Ayllón" />
<meta name="DC.Contributor" content="N. Dulguerov" />
<meta name="DC.Contributor" content="M. Pusztaszeri" />
<meta name="DC.Contributor" content="M. Becker" />
<meta name="article:published_time" content="2017-09-14" />
<meta name="article:section" content="HEAD &amp;amp; NECK" />
<meta name="citation_title" content="Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Head and neck squamous cell carcinoma associated with human papillomavirus infection represents a distinct tumor entity. We hypothesized that diffusion phenotypes based on the histogram analysis of ADC values reflect distinct degrees of tumor heterogeneity in human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;One hundred five consecutive patients (mean age, 64 years; range, 45–87 years) with primary oropharyngeal (&lt;i&gt;n&lt;/i&gt; = 52) and oral cavity (&lt;i&gt;n&lt;/i&gt; = 53) head and neck squamous cell carcinoma underwent MR imaging with anatomic and diffusion-weighted sequences (&lt;i&gt;b&lt;/i&gt; = 0, &lt;i&gt;b&lt;/i&gt; = 1000 s/mm&lt;sup&gt;2&lt;/sup&gt;, monoexponential ADC calculation). The collected tumor voxels from the contoured ROIs provided histograms from which position, dispersion, and form parameters were computed. Histogram data were correlated with histopathology, p16-immunohistochemistry, and polymerase chain reaction for human papillomavirus DNA.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;There were 21 human papillomavirus–positive and 84 human papillomavirus–negative head and neck squamous cell carcinomas. At histopathology, human papillomavirus–positive cancers were more often nonkeratinizing (13/21, 62%) than human papillomavirus–negative cancers (19/84, 23%; &lt;i&gt;P&lt;/i&gt; = .001), and their mitotic index was higher (71% versus 49%; &lt;i&gt;P&lt;/i&gt; = .005). ROI-based mean and median ADCs were significantly lower in human papillomavirus–positive (1014 ± 178 × 10&lt;sup&gt;−6&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and 970 ± 187 × 10&lt;sup&gt;−6&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s, respectively) than in human papillomavirus–negative tumors (1184 ± 168 × 10&lt;sup&gt;−6&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and 1161 ± 175 × 10&lt;sup&gt;−6&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s, respectively; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001), whereas excess kurtosis and skewness were significantly higher in human papillomavirus–positive (1.934 ± 1.386 and 0.923 ± 0.510, respectively) than in human papillomavirus–negative tumors (0.643 ± 0.982 and 0.399 ± 0.516, respectively; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001). Human papillomavirus–negative head and neck squamous cell carcinoma had symmetric normally distributed ADC histograms, which corresponded histologically to heterogeneous tumors with variable cellularity, high stromal component, keratin pearls, and necrosis. Human papillomavirus–positive head and neck squamous cell carcinomas had leptokurtic skewed right histograms, which corresponded to homogeneous tumors with back-to-back densely packed cells, scant stromal component, and scattered comedonecrosis.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Diffusion phenotypes of human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas show significant differences, which reflect their distinct degree of tumor heterogeneity.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2017/09/14" />
<meta name="citation_mjid" content="ajnr;ajnr.A5370v2" />
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<meta name="citation_abstract_html_url" content="http://ajnr-stage2.stage.highwire.org/content/early/2017/09/21/ajnr.A5370.abstract" />
<meta name="citation_full_html_url" content="http://ajnr-stage2.stage.highwire.org/content/early/2017/09/21/ajnr.A5370.full" />
<meta name="citation_pdf_url" content="http://ajnr-stage2.stage.highwire.org/content/ajnr/early/2017/09/21/ajnr.A5370.full.pdf" />
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<meta name="citation_author" content="T. de Perrot" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8053-6064" />
<meta name="citation_author" content="V. Lenoir" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-8140-8010" />
<meta name="citation_author" content="M. Domingo Ayllón" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-6422-050X" />
<meta name="citation_author" content="N. Dulguerov" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8676-3698" />
<meta name="citation_author" content="M. Pusztaszeri" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-6490-4189" />
<meta name="citation_author" content="M. Becker" />
<meta name="citation_author_institution" content="From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-9644-9053" />
<meta name="citation_fulltext_world_readable" content="" />
<meta name="twitter:title" content="Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Head and neck squamous cell carcinoma associated with human papillomavirus infection represents a distinct tumor entity. We hypothesized that diffusion phenotypes based on the histogram analysis of ADC values reflect distinct degrees of tumor heterogeneity in human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas.

MATERIALS AND METHODS: One hundred five consecutive patients (mean age, 64 years; range, 45–87 years) with primary oropharyngeal ( n = 52) and oral cavity ( n = 53) head and neck squamous cell carcinoma underwent MR imaging with anatomic and diffusion-weighted sequences ( b = 0, b = 1000 s/mm2, monoexponential ADC calculation). The collected tumor voxels from the contoured ROIs provided histograms from which position, dispersion, and form parameters were computed. Histogram data were correlated with histopathology, p16-immunohistochemistry, and polymerase chain reaction for human papillomavirus DNA.

RESULTS: There were 21 human papillomavirus–positive and 84 human papillomavirus–negative head and neck squamous cell carcinomas. At histopathology, human papillomavirus–positive cancers were more often nonkeratinizing (13/21, 62%) than human papillomavirus–negative cancers (19/84, 23%; P = .001), and their mitotic index was higher (71% versus 49%; P = .005). ROI-based mean and median ADCs were significantly lower in human papillomavirus–positive (1014 ± 178 × 10−6 mm2/s and 970 ± 187 × 10−6 mm2/s, respectively) than in human papillomavirus–negative tumors (1184 ± 168 × 10−6 mm2/s and 1161 ± 175 × 10−6 mm2/s, respectively; P &lt; .001), whereas excess kurtosis and skewness were significantly higher in human papillomavirus–positive (1.934 ± 1.386 and 0.923 ± 0.510, respectively) than in human papillomavirus–negative tumors (0.643 ± 0.982 and 0.399 ± 0.516, respectively; P &lt; .001). Human papillomavirus–negative head and neck squamous cell carcinoma had symmetric normally distributed ADC histograms, which corresponded histologically to heterogeneous tumors with variable cellularity, high stromal component, keratin pearls, and necrosis. Human papillomavirus–positive head and neck squamous cell carcinomas had leptokurtic skewed right histograms, which corresponded to homogeneous tumors with back-to-back densely packed cells, scant stromal component, and scattered comedonecrosis.

CONCLUSIONS: Diffusion phenotypes of human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas show significant differences, which reflect their distinct degree of tumor heterogeneity.

### Abbreviations

HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
HPV−
:   human papillomavirus–negative
HPV+
:   human papillomavirus–positive" />
<meta name="og-title" property="og:title" content="Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2017/09/21/ajnr.A5370" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Head and neck squamous cell carcinoma associated with human papillomavirus infection represents a distinct tumor entity. We hypothesized that diffusion phenotypes based on the histogram analysis of ADC values reflect distinct degrees of tumor heterogeneity in human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas.

MATERIALS AND METHODS: One hundred five consecutive patients (mean age, 64 years; range, 45–87 years) with primary oropharyngeal ( n = 52) and oral cavity ( n = 53) head and neck squamous cell carcinoma underwent MR imaging with anatomic and diffusion-weighted sequences ( b = 0, b = 1000 s/mm2, monoexponential ADC calculation). The collected tumor voxels from the contoured ROIs provided histograms from which position, dispersion, and form parameters were computed. Histogram data were correlated with histopathology, p16-immunohistochemistry, and polymerase chain reaction for human papillomavirus DNA.

RESULTS: There were 21 human papillomavirus–positive and 84 human papillomavirus–negative head and neck squamous cell carcinomas. At histopathology, human papillomavirus–positive cancers were more often nonkeratinizing (13/21, 62%) than human papillomavirus–negative cancers (19/84, 23%; P = .001), and their mitotic index was higher (71% versus 49%; P = .005). ROI-based mean and median ADCs were significantly lower in human papillomavirus–positive (1014 ± 178 × 10−6 mm2/s and 970 ± 187 × 10−6 mm2/s, respectively) than in human papillomavirus–negative tumors (1184 ± 168 × 10−6 mm2/s and 1161 ± 175 × 10−6 mm2/s, respectively; P &lt; .001), whereas excess kurtosis and skewness were significantly higher in human papillomavirus–positive (1.934 ± 1.386 and 0.923 ± 0.510, respectively) than in human papillomavirus–negative tumors (0.643 ± 0.982 and 0.399 ± 0.516, respectively; P &lt; .001). Human papillomavirus–negative head and neck squamous cell carcinoma had symmetric normally distributed ADC histograms, which corresponded histologically to heterogeneous tumors with variable cellularity, high stromal component, keratin pearls, and necrosis. Human papillomavirus–positive head and neck squamous cell carcinomas had leptokurtic skewed right histograms, which corresponded to homogeneous tumors with back-to-back densely packed cells, scant stromal component, and scattered comedonecrosis.

CONCLUSIONS: Diffusion phenotypes of human papillomavirus–positive and human papillomavirus–negative head and neck squamous cell carcinomas show significant differences, which reflect their distinct degree of tumor heterogeneity.

### Abbreviations

HNSCC
:   head and neck squamous cell carcinoma
HPV
:   human papillomavirus
HPV−
:   human papillomavirus–negative
HPV+
:   human papillomavirus–positive" />
<meta name="og-type" property="og:type" content="article" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node56139--5" data-node-nid="56139" id="top-node-56139--6424365469" data-pisa="ajnr;ajnr.A5370v2" data-pisa-master="ajnr;ajnr.A5370" data-apath="/ajnr/early/2017/09/21/ajnr.A5370.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">HEAD &amp; NECK</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T. de Perrot</span>, <span class="highwire-citation-author" data-delta="1">V. Lenoir</span>, <span class="highwire-citation-author" data-delta="2">M. Domingo Ayllón</span>, <span class="highwire-citation-author" data-delta="3">N. Dulguerov</span>, <span class="highwire-citation-author" data-delta="4">M. Pusztaszeri</span> and <span class="highwire-citation-author" data-delta="5">M. Becker</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2017,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5370 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-56139--6424365469" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T. de Perrot </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2Bde%2BPerrot%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=de%20Perrot%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2Bde%2BPerrot%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8053-6064" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. de Perrot</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">V. Lenoir </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BLenoir%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lenoir%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AV.%2BLenoir%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-8140-8010" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. Lenoir</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Domingo Ayllón </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BDomingo%2BAyll%C3%B3n%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Domingo%20Ayll%C3%B3n%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BDomingo%2BAyll%25C3%25B3n%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6422-050X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Domingo Ayllón</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">N. Dulguerov </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BDulguerov%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dulguerov%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.%2BDulguerov%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-8676-3698" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. 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Pusztaszeri </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Radiology, Department of Imaging and Medical Informatics (T.d.P., V.L., M.D.A., M.B.), Division of Head and Neck Surgery, Department of Clinical Neurosciences (N.D.), and Division of Clinical Pathology, Department of Genetic and Laboratory Medicine (M.P.), Geneva University Hospitals, Geneva, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BPusztaszeri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pusztaszeri%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BPusztaszeri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6490-4189" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. 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      <div class="highwire-cite-title">Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.</span> <span class="nlm-surname">de Perrot</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Lenoir</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Domingo Ayllón</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Dulguerov</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Pusztaszeri</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Becker</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2017, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5370 </span></div>
  
  
  
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      <div class="highwire-cite-title">Apparent Diffusion Coefficient Histograms of Human Papillomavirus–Positive and Human Papillomavirus–Negative Head and Neck Squamous Cell Carcinoma: Assessment of Tumor Heterogeneity and Comparison with Histopathology</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.</span> <span class="nlm-surname">de Perrot</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Lenoir</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Domingo Ayllón</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Dulguerov</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Pusztaszeri</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Becker</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2017, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5370 </span></div>
  
  
  
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