Chen T, Li Y, Lu S-S, Zhang Y-D, Wang X-N, Luo C-Y, Shi H-B
Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guang Zhou Road, Nanjing, 210029, Jiangsu Province, China.
Department of Gynaecology and Obstetrics, First Affiliated Hospital of Nanjing Medical University, 300 Guang Zhou Road, Nanjing, 210029, Jiangsu Province, China.
Clin Radiol. 2017 Nov;72(11):995.e11-995.e20. doi: 10.1016/j.crad.2017.07.004. Epub 2017 Jul 31.
To evaluate the diagnostic performance of histogram analysis of diffusion kurtosis magnetic resonance imaging (DKI) and standard diffusion-weighted imaging (DWI) in discriminating tumour grades of endometrial carcinoma (EC).
Seventy-three patients with EC were included in this study. The apparent diffusion coefficient (ADC) value from standard DWI, apparent diffusion for Gaussian distribution (D), and apparent kurtosis coefficient (K) from DKI were acquired using a 3 T magnetic resonance imaging (MRI) system. The measurement was based on an entire-tumour analysis. Histogram parameters (D, K, and ADC) were compared between high-grade (grade 3) and low-grade (grade 1 and 2) tumours. The diagnostic performance of imaging parameters for discriminating high- from low-grade tumours was analysed using a receiver operating characteristic curve (ROC).
The area under the ROC curve (AUC) of the 10th percentile of D, 90th percentile of K and 10th percentile of ADC were higher than other parameters in distinguishing high-grade tumours from low-grade tumours (AUC=0.821, 0.891 and 0.801, respectively). The combination of 10th percentile of D and 90th percentile of K improved the AUC to 0.901, which was significantly higher than that of the 10th percentile of ADC (0.810, p=0.0314) in differentiating high- from low-grade EC.
Entire-tumour volume histogram analysis of DKI and standard DWI were feasible for discriminating histological tumour grades of EC. DKI was relatively better than DWI in distinguishing high-grade from low-grade tumour in EC.
评估扩散峰度磁共振成像（DKI）和标准扩散加权成像（DWI）的直方图分析在鉴别子宫内膜癌（EC）肿瘤分级中的诊断性能。
本研究纳入73例EC患者。使用3T磁共振成像（MRI）系统获取标准DWI的表观扩散系数（ADC）值、DKI的高斯分布表观扩散（D）和表观峰度系数（K）。测量基于全肿瘤分析。比较高级别（3级）和低级别（1级和2级）肿瘤之间的直方图参数（D、K和ADC）。使用受试者操作特征曲线（ROC）分析成像参数鉴别高低级别肿瘤的诊断性能。
在区分高级别肿瘤和低级别肿瘤方面，D的第10百分位数、K的第90百分位数和ADC的第10百分位数的ROC曲线下面积（AUC）高于其他参数（分别为AUC = 0.821、0.891和0.801）。D的第10百分位数和K的第90百分位数相结合可将AUC提高至0.901，在区分高低级别EC方面显著高于ADC的第10百分位数（0.810，p = 0.0314）。
DKI和标准DWI的全肿瘤体积直方图分析对于鉴别EC的组织学肿瘤分级是可行的。在区分EC的高级别和低级别肿瘤方面，DKI相对优于DWI。
