From the Department of Radiology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan (Y.T.); Departments of Clinical Radiology (Y.T., A.N., O.T., K.I., Y.U., D.O., N.F., H.H.), Advanced Imaging and Interventional Radiology (Y.A.), Gynecology and Obstetrics (K.S.), and Anatomic Pathology (T.H., Y.O.), Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka 812-8582, Japan; and Philips Research, Hamburg, Germany (J.K.).
Radiology. 2018 Mar;286(3):909-917. doi: 10.1148/radiol.2017170349. Epub 2017 Oct 30.
Purpose To evaluate the utility of amide proton transfer (APT) imaging in estimating histologic grades of endometrioid endometrial adenocarcinoma (EEA). Materials and Methods The institutional review board approved this prospective study. Between June 2012 and March 2016, 32 patients with EEA underwent magnetic resonance (MR) imaging. After their surgical procedures, their EEAs were confirmed pathologically and classified into histologic grades: grade 1 (n = 11), grade 2 (n = 11), and grade 3 (n = 10). The APT signal intensities (SIs) and the mean and minimum apparent diffusion coefficients (ADCs) of the three grades were calculated and compared. Spearman rank correlation coefficient was also calculated between the APT SIs and histologic grades, and between the ADCs and histologic grades. Results The Spearman correlation coefficient with histologic grade of the APT SIs, the mean ADC, and the minimum ADC were 0.55 (P = .001), 0.03 (P = .84), and -0.30 (P = .09), respectively. The average APT SIs and the mean and minimum ADCs were 2.2% ± 0.2 (standard deviation), 0.9 × 10 mm/sec ± 0.2, and 0.6 × 10 mm/sec ± 0.1 for grade 1; 3.2% ± 0.3, 0.8 × 10 mm/sec ± 0.1, and 0.5 × 10 mm/sec ± 0.1 for grade 2; and 3.7% ± 0.3, 0.9 × 10 mm/sec ± 0.1, and 0.5 × 10 mm/sec ± 0.1 for grade 3, respectively. The APT SIs of grade 3 EEA were significantly higher than those of grade 1 EEA (P = .01), but other pairwise comparisons did not reveal any significant differences (P = .06-.51). The mean and minimum ADCs showed no significant differences among the three histologic grades (P =.13-.51). Conclusion The APT SI was positively correlated with the histologic grades of EEA. RSNA, 2017 Online supplemental material is available for this article.
目的 评估酰胺质子转移（APT）成像在估计子宫内膜样型子宫内膜腺癌（EEA）组织学分级中的效用。
材料与方法 本研究经机构审查委员会批准。2012 年 6 月至 2016 年 3 月，32 例 EEA 患者接受了磁共振（MR）成像检查。在他们的手术之后，他们的 EEA 通过病理检查得到确认，并分为组织学分级：1 级（n = 11）、2 级（n = 11）和 3 级（n = 10）。计算并比较了这 3 个分级的 APT 信号强度（SI）以及平均和最小表观扩散系数（ADC）。还计算了 APT SI 与组织学分级之间以及 ADC 与组织学分级之间的 Spearman 秩相关系数。
结果 APT SI、平均 ADC 和最小 ADC 与组织学分级的 Spearman 相关系数分别为 0.55（P =.001）、0.03（P =.84）和-0.30（P =.09）。1 级的平均 APT SI、平均 ADC 和最小 ADC 分别为 2.2% ± 0.2（标准差）、0.9 × 10 mm/sec ± 0.2 和 0.6 × 10 mm/sec ± 0.1；2 级分别为 3.2% ± 0.3、0.8 × 10 mm/sec ± 0.1 和 0.5 × 10 mm/sec ± 0.1；3 级分别为 3.7% ± 0.3、0.9 × 10 mm/sec ± 0.1 和 0.5 × 10 mm/sec ± 0.1。3 级 EEA 的 APT SI 明显高于 1 级 EEA（P =.01），但其他两两比较没有发现任何显著差异（P =.06-.51）。3 种组织学分级之间的平均 ADC 和最小 ADC 无显著差异（P =.13-.51）。
结论 APT SI 与 EEA 的组织学分级呈正相关。
RSNA，2017 在线补充材料可从本文获得。
