Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, Postbox 7800, 5021, Bergen, Norway,
Eur Radiol. 2013 Oct;23(10):2916-25. doi: 10.1007/s00330-013-2901-3. Epub 2013 Jun 4.
To study the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for assessment of tumour microvasculature in endometrial carcinoma patients, and to explore correlations with histological subtype, clinical course and microstructural characteristics based on apparent diffusion coefficient (ADC) values.
Diffusion-weighted imaging (DWI) and three-dimensional DCE-MRI (1.5 T) with high temporal resolution (2.49 s) were acquired preoperatively in 55 patients. Quantitative modelling allowed the calculation of four independent parameters describing microvasculature: blood flow (Fb), extraction fraction (E), capillary transit time (Tc) and transfer constant from the extravascular extracellular space [EES] to blood (Kep); and four derived parameters: blood volume (Vb), volume of EES (Ve), capillary permeability surface area product (PS) and transfer from blood to EES (Ktrans).
Endometrial carcinoma tissue exhibited reduced Fb, E, Vb, Ve, PS and Ktrans compared with normal myometrium. Non-endometrioid carcinomas (n = 12) had lower Fb, and E than endometrioid carcinomas (n = 43; P < 0.05). Tumour Ve positively correlated with tumour ADC value (r = 0.29, P = 0.03). Reduced survival was observed in patients with low tumour Fb and high tumour Tc (P < 0.05).
We demonstrate the feasibility of DCE-MRI in reflecting histological subtype and clinical course in primary endometrial carcinomas. DCE-MRI may potentially provide future biomarkers for preoperative risk stratification in endometrial carcinomas.
• Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers new information about endometrial carcinoma. • Pelvic DCE-MRI with subsequent quantitative modelling seems feasible in endometrial carcinoma patients. • Low tumour perfusion is a feature of a more aggressive tumour subtype. • DCE-MRI provides potential biomarkers for preoperative risk stratification in endometrial carcinoma patients.
研究动态对比增强磁共振成像（DCE-MRI）评估子宫内膜癌患者肿瘤微血管的可行性，并基于表观扩散系数（ADC）值探讨与组织学亚型、临床病程和微观结构特征的相关性。
对 55 例患者术前进行了扩散加权成像（DWI）和三维 DCE-MRI（1.5 T）检查，具有高时间分辨率（2.49 s）。定量建模允许计算四个独立的参数来描述微血管：血流（Fb）、提取分数（E）、毛细血管渡越时间（Tc）和从血管外细胞外空间[EES]到血液的转移常数（Kep）；以及四个衍生参数：血容量（Vb）、EES 体积（Ve）、毛细血管通透性表面积乘积（PS）和从血液到 EES 的转移（Ktrans）。
与正常子宫肌层相比，子宫内膜癌组织的 Fb、E、Vb、Ve、PS 和 Ktrans 降低。非子宫内膜样癌（n=12）的 Fb 和 E 低于子宫内膜样癌（n=43；P<0.05）。肿瘤 Ve 与肿瘤 ADC 值呈正相关（r=0.29，P=0.03）。低肿瘤 Fb 和高肿瘤 Tc 的患者生存率降低（P<0.05）。
我们证明了 DCE-MRI 在反映原发性子宫内膜癌的组织学亚型和临床病程方面的可行性。DCE-MRI 可能为子宫内膜癌的术前风险分层提供未来的生物标志物。
• DCE-MRI 提供了有关子宫内膜癌的新信息。
• 盆腔 DCE-MRI 联合后续定量建模似乎在子宫内膜癌患者中可行。
• 低肿瘤灌注是侵袭性肿瘤亚型的特征。
• DCE-MRI 为子宫内膜癌患者的术前风险分层提供了潜在的生物标志物。
