Application of the amide proton transfer-weighted imaging and diffusion kurtosis imaging in the study of cervical cancer
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MAGNETIC RESONANCE
Application of the amide proton transfer-weighted imaging and diffusion kurtosis imaging in the study of cervical cancer Nan Meng 1,2 & Xuejia Wang 3 & Jing Sun 4 & Dongming Han 3 & Xiaoyue Ma 1,2 & Kaiyu Wang 5 & Meiyun Wang 1,2 Received: 18 December 2019 / Revised: 16 March 2020 / Accepted: 9 April 2020 # European Society of Radiology 2020
Abstract Objectives To analyze the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in differentiating cervical cancer (CC) pathological type, grade, and stage. Methods One hundred and twelve women underwent pelvic APTWI and DKI. The magnetization transfer ratio asymmetry (MTRasym, 3.5 ppm), apparent kurtosis coefficient (Kapp), and non-Gaussian diffusion coefficient (Dapp) were calculated by histological subtype, grade, and stage. The differences, efficacy, and correlation between parameters were determined. Results The MTRasym(3.5 ppm) and Dapp values of the adenocarcinoma (CA) group were higher than those of the cervical squamous carcinoma (CSC) group, while the Kapp values were lower than those of the CSC group. The MTRasym(3.5 ppm) and Kapp values of the high-grade group were higher than those of the low-grade group, while the Dapp values were lower than those of the low-grade group. The Dapp values of the advanced-stage group were lower than those of the early-stage group, while the Kapp values were greater than those of the early-stage group. The Kapp showed the highest efficacy in differentiating CSC and CA, high- and low-grade CC, and advanced- and early-stage CC. In the CSC and CA groups, both the Kapp and Dapp were highly correlated with pathological grade, and the MTRasym(3.5 ppm) was weakly correlated with pathological grade. The Kapp, Dapp, and MTRasym(3.5 ppm) were all weakly correlated with pathological stage. Conclusion Both DKI and APTWI can be used in preliminary evaluations of CC, but DKI has advantages in the identification of pathological type, grade, and stage. Key Points • PTWI and DKI provide new information regarding cervical cancer. • MTRasym(3.5 ppm), Dapp, and Kapp are valid parameters to characterize tissue microstructure. • DKI is superior to APTWI in the study of cervical cancer. Keywords Cervical cancer . Amide proton transfer-weighted imaging . Diffusion kurtosis imaging
Nan Meng and Xuejia Wang contributed equally to this work and should be considered co-first authors. * Meiyun Wang [email protected] 1
Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, Henan, China
2
Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
3
Department of MR, the First Affiliated Hospital, Xinxiang Medical University, Weihui, China
4
Department of Pediatrics, Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou, China
5
MR Research China, GE Healthcare, Beijing, China
Abbreviations APTWI Amide proton transfer-weighted imaging AUC Area under the curve CA Cervical adenocarcinoma CC Cervical cancer CSC C
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