早期宫颈癌的体素内不相干运动与动态对比增强灌注 MRI 联合应用：多模态参数与 HIF-1α 表达的相关性。
Intravoxel Incoherent Motion Combined With Dynamic Contrast-Enhanced Perfusion MRI of Early Cervical Carcinoma: Correlations Between Multimodal Parameters and HIF-1α Expression.
机构信息
Department of Radiology, Air Force General Hospital, People's Liberation Army, Beijing, China.
Imaging Research Division Department of Radiology, Biomedical Informatics, and Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
J Magn Reson Imaging. 2019 Sep;50(3):918-929. doi: 10.1002/jmri.26604. Epub 2019 Jan 16.
BACKGROUND
The identification of hypoxia inducible factor (HIF-1α) expression is helpful for the quantitative assessment of tumor hypoxia. The application of multimodal imaging techniques may play a part in the assessment of HIF-1α expression of cervical carcinoma.
PURPOSE
To investigate the correlations between multiple imaging parameters and HIF-1α expression of early cervical carcinoma and to determine whether tumor hypoxia can be predicted using multisequence imaging parameters.
STUDY TYPE
Prospective observational.
POPULATION
One hundred patients with early cervical carcinoma.
FIELD STRENGTH/SEQUENCES: 3.0 T MRI including intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) perfusion MRI sequences.
ASSESSMENT
DCE-MRI and IVIM DWI were performed for all patients. The imaging parameters included volume transfer constant (K ), rate constant (K ), extravascular extracellular volume fraction (V ), D, D*, and f.
STATISTICAL TESTS
The comparisons of imaging parameters between two independent groups were performed using the Mann-Whitney U-test. Multiple linear regression analysis was performed to determine the correlation between multiple imaging parameters and HIF-1α expression. The diagnostic ability of DCE-MRI, IVIM DWI, and the combination of two techniques for discriminating high-expression and low-expression groups were analyzed.
RESULTS
The high-expression group had a lower K or K value than the low-expression group (P = 0.03; 0.02), while the high-expression group had a higher V value than the low-expression group (P = 0.03). The high-expression group had a higher D or f value than the low-expression group (P = 0.02; 0.02). K , K , D, V , and f values were independently correlated with HIF-1α expression. The sensitivity or accuracy of a combined method was higher than that of DCE-MRI or IVIM DWI individually (P = 0.03, 0.02; 0.04, 0.03).
DATA CONCLUSION
The combination of DCE-MRI and IVIM DWI can improve the diagnostic ability of discriminating different HIF-1α expression levels for early cervical tumors.
LEVEL OF EVIDENCE
1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:918-929.
背景
缺氧诱导因子（HIF-1α）表达的鉴定有助于对肿瘤缺氧进行定量评估。多模态成像技术的应用可能在评估宫颈癌的 HIF-1α表达中发挥作用。
目的
探讨早期宫颈癌多模态成像参数与 HIF-1α表达的相关性，并确定是否可以通过多序列成像参数预测肿瘤缺氧。
研究类型
前瞻性观察研究。
人群
100 例早期宫颈癌患者。
磁场强度/序列：3.0T MRI 包括体素内不相干运动（IVIM）扩散加权成像（DWI）和动态对比增强（DCE）灌注 MRI 序列。
评估
所有患者均行 DCE-MRI 和 IVIM DWI 检查。成像参数包括容积转移常数（K ）、速率常数（K ）、细胞外血管外容积分数（V ）、D、D*和 f。
统计学检验
采用 Mann-Whitney U 检验比较两组间的成像参数。采用多元线性回归分析确定多个成像参数与 HIF-1α表达的相关性。分析 DCE-MRI、IVIM DWI 及两种技术联合对鉴别高表达和低表达组的诊断能力。
结果
高表达组的 K 或 K 值低于低表达组（P = 0.03；0.02），而高表达组的 V 值高于低表达组（P = 0.03）。高表达组的 D 或 f 值高于低表达组（P = 0.02；0.02）。K 、K 、D、V 和 f 值与 HIF-1α表达均独立相关。联合方法的敏感性或准确性均高于 DCE-MRI 或 IVIM DWI 单独检查（P = 0.03、0.02；0.04、0.03）。
数据结论
DCE-MRI 与 IVIM DWI 相结合可提高鉴别早期宫颈癌不同 HIF-1α表达水平的诊断能力。
证据水平
1 技术功效分期：2 J. Magn. Reson. Imaging 2019;50:918-929.
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