Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
Department of OB&GYN, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
J Magn Reson Imaging. 2019 Oct;50(4):1318-1325. doi: 10.1002/jmri.26710. Epub 2019 Mar 12.
Amide proton transfer-weighted (APTw) imaging has shown great potential in the diagnosis of cancer, but has yet not been well studied in cervical cancer.
To evaluate the image quality and clinical feasibility of APTw MRI for cervical cancer.
Prospective.
In all, 75 patients with cervical lesions and 49 healthy volunteers.
FIELD STRENGTH/SEQUENCE: 3.0 T, 3D turbo spin echo (TSE) APTw sequence.
Three radiologists, blinded to the clinical data, independently evaluated APTw image quality with a 5-point Likert scale on 64 patients with pathologically confirmed cervical cancer. APT values, calculated based on asymmetry of acquired Z-spectrum with respect to water frequency, using 3D turbo spin echo volume acquisition with B correction, were independently measured by two radiologists, twice for each observer, on 52 cervical cancer lesions and 49 normal cervical stroma with a mean region of interest area of 638.6 mm and 557.5 mm , respectively.
Interobserver agreement was evaluated by Kendall's W test. Intra- and interobserver interclass correlation coefficients (ICC) were computed. Student's t-test was used to compare the differences of APT values between cervical cancer and normal cervix; receiver operating characteristic analysis was performed.
Most cases revealed good APTw image quality with excellent agreement (Kendall's W = 0.850, P < 0.001). APT values of cervical cancer and normal cervical stroma were 2.745 ± 0.065 and 1.853 ± 0.059, respectively, with a significant difference (P < 0.0001). Intraobserver ICCs were 0.963 and 0.960 for two readers. Interobserver ICC was 0.993. Area under the curve (AUC) for differentiating cervical cancer from normal cervical stroma was 0.927. The feasible threshold value for AUC was determined as 2.221 with sensitivity of 84.62% and specificity of 83.66%.
3D TSE APTw MRI is feasible in cervical cancer. Cervical cancer showed significantly higher APT values than normal cervix.
2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1318-1325.
酰胺质子转移加权（APTw）成像在癌症诊断中显示出巨大的潜力，但在宫颈癌中的研究还不够充分。
评估 APTw MRI 对宫颈癌的图像质量和临床可行性。
前瞻性。
共有 75 名宫颈病变患者和 49 名健康志愿者。
磁场强度/序列：3.0T，3D 涡轮自旋回波（TSE）APTw 序列。
3 名放射科医生在不知道临床数据的情况下，对 64 名经病理证实的宫颈癌患者的 APTw 图像质量进行了 5 分李克特量表独立评估。基于水频率的获得 Z 谱的不对称性，使用 B 校正的 3D 涡轮自旋回波容积采集，由 2 名放射科医生独立测量了 52 例宫颈癌病变和 49 例正常宫颈基质的 APT 值，每个观察者测量两次，感兴趣区的平均面积分别为 638.6mm 和 557.5mm。
采用 Kendall's W 检验评估观察者间一致性。计算了观察者内和观察者间的组内相关系数（ICC）。采用 Student's t 检验比较宫颈癌与正常宫颈之间的 APT 值差异；进行了受试者工作特征（ROC）分析。
大多数病例的 APTw 图像质量良好，一致性极佳（Kendall's W=0.850，P<0.001）。宫颈癌和正常宫颈基质的 APT 值分别为 2.745±0.065 和 1.853±0.059，差异有统计学意义（P<0.0001）。两位观察者的观察者内 ICC 分别为 0.963 和 0.960。观察者间 ICC 为 0.993。鉴别宫颈癌与正常宫颈基质的曲线下面积（AUC）为 0.927。确定 AUC 的可行阈值为 2.221，其敏感性为 84.62%，特异性为 83.66%。
3D TSE APTw MRI 对宫颈癌是可行的。宫颈癌的 APT 值明显高于正常宫颈。
2 技术功效：第 2 阶段 J. 磁共振成像 2019；50：1318-1325。
