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.
J Magn Reson Imaging. 2019 Sep;50(3):918-929. doi: 10.1002/jmri.26604. Epub 2019 Jan 16.
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.
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.
Prospective observational.
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.
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.
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.
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).
The combination of DCE-MRI and IVIM DWI can improve the diagnostic ability of discriminating different HIF-1α expression levels for early cervical tumors.
1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:918-929.
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。
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。
前瞻性观察研究。
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。
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。
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。
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）。
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。
1 技术功效分期：2 J. Magn. Reson. Imaging 2019;50:918-929.
