Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China.
Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China.
Clin Radiol. 2019 Dec;74(12):918-925. doi: 10.1016/j.crad.2019.07.019. Epub 2019 Aug 27.
To investigate whether apparent diffusion coefficient (ADC) histogram parameters based on whole solid tumour volume could differentiate high-grade (HGSOC) from low-grade serous ovarian carcinoma (LGSOC) and to correlate those parameters with the Ki-67 proliferation index.
One hundred and seven patients with HGSOCs and 19 patients with LGSOCs confirmed at surgery and histology who underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) were analysed retrospectively. ADC histogram parameters (including the mean, standard deviation [SD], 10th, 25th, 50th, 75th, and 90th percentiles, kurtosis, and skewness) were obtained using the whole solid tumour volume region of interest (ROI). The Mann-Whitney U test, Pearson's chi-square test, Fisher's exact test, kappa test, Spearman's correlation, and receiver operating characteristic (ROC) curves were used for statistical analyses.
For ADC histogram parameters, the mean (p<0.001), SD (p=0.003), and all percentiles (10th, 25th, 50th, 75th, and 90th percentile; all p<0.001) were significantly lower in HGSOC than in LGSOC, and the area under the ROC curve (AUC) was 0.717-0.807. Skewness was significantly higher in HGSOC than in LGSOC (p<0.001, AUC = 0.773); however, kurtosis was not significantly different between HGSOC and LGSOC (p=0.140). The 25th and 75th percentiles, SD and 10th percentile, and 75th percentile showed the highest sensitivity of 91.6%, specificity of 79.0%, and accuracy of 88.1%, respectively. All histogram parameters (except for kurtosis) were poorly correlated with the Ki-67 index (|r| = 0.191-0.274, p<0.05).
ADC histogram parameters based on whole solid tumour volume can be helpful for differentiating between HGSOC and LGSOC.
探讨基于全实体肿瘤体积的表观扩散系数（ADC）直方图参数能否区分高级别浆液性卵巢癌（HGSOC）和低级别浆液性卵巢癌（LGSOC），并将这些参数与 Ki-67 增殖指数相关联。
回顾性分析了 107 例经手术和组织学证实的 HGSOC 患者和 19 例 LGSOC 患者，这些患者均接受了常规磁共振成像（MRI）和扩散加权成像（DWI）检查。使用全实体肿瘤体积 ROI 获得 ADC 直方图参数（包括平均值、标准差[SD]、第 10、25、50、75 和 90 百分位数、峰度和偏度）。采用 Mann-Whitney U 检验、Pearson 卡方检验、Fisher 确切检验、kappa 检验、Spearman 相关和受试者工作特征（ROC）曲线进行统计学分析。
对于 ADC 直方图参数，HGSOC 的平均值（p<0.001）、SD（p=0.003）和所有百分位数（第 10、25、50、75 和 90 百分位数；均 p<0.001）均显著低于 LGSOC，ROC 曲线下面积（AUC）为 0.717-0.807。HGSOC 的偏度明显高于 LGSOC（p<0.001，AUC=0.773）；然而，HGSOC 和 LGSOC 之间的峰度无显著差异（p=0.140）。第 25 和 75 百分位数、SD 和第 10 百分位数以及 75 百分位数的敏感性最高，分别为 91.6%、特异性为 79.0%和准确性为 88.1%。所有直方图参数（峰度除外）与 Ki-67 指数相关性均较差（|r|=0.191-0.274，p<0.05）。
基于全实体肿瘤体积的 ADC 直方图参数有助于区分 HGSOC 和 LGSOC。
