Liu Nian, Yang Xiongxiong, Lei Lixing, Pan Ke, Liu Qianqian, Huang Xiaohua
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China.
Front Oncol. 2021 Apr 12;11:625891. doi: 10.3389/fonc.2021.625891. eCollection 2021.
To compare the diagnostic efficiency of the mono-exponential model and bi-exponential model deriving from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating the pathological grade of esophageal squamous cell carcinoma (ESCC).
Fifty-four patients with ESCC were divided into three groups of poorly-differentiated (PD), moderately-differentiated (MD), and well-differentiated (WD), and underwent the IVIM-DWI scan. Mono-exponential (D, D*, and f) and bi-exponential fit parameters (D, D*, and f) were calculated using the IVIM data for the tumors. Mean parameter values of three groups were compared using a one-way ANOVA followed by tests. The receiver operating characteristic curve was drawn for differentiating pathological grade of ESCC. Correlations between pathological grades and IVIM parameters were analyzed.
There were significant differences in f and f among the PD, MD and WD ESCC groups (all p<0.05). The f were 0.32 ± 0.07, 0.23 ± 0.08, and 0.16 ± 0.05, respectively, and the f were 0.35 ± 0.08, 0.26 ± 0.10, and 0.18 ± 0.07, respectively. There was a significant difference in the D between the WD and the PD group (1.48 ± 0.51* 10 mm/s versus 1.05 ± 0.4410 mm/s, p<0.05), but there was no significant difference between the WD and MD groups, MD and PD groups (all p>0.05). The D, D, and D* showed no significant difference among the three groups (all p>0.05). The area under the curve (AUC) of D, f and f in differentiating WD from PD ESCC were 0.764, 0.961 and 0.932, and the sensitivity and specificity were 92.9% and 60%, 92.9% and 90%, 85.7% and 100%, respectively. The AUC of f and f in differentiating MD from PD ESCC were 0.839 and 0.757, and the sensitivity and specificity were 78.6% and 80%, 85.7% and 70%, respectively. The AUC of f and f in differentiating MD from WD ESCC were 0.746 and 0.740, and the sensitivity and specificity were 65% and 85%, 80% and 60%, respectively. The pathologically differentiated grade was correlated with all IVIM parameters (all p<0.05).
The mono-exponential IVIM model is superior to the bi-exponential IVIM model in differentiating pathological grades of ESCC, which may be a promising imaging method to predict pathological grades of ESCC.
比较体素内不相干运动扩散加权成像（IVIM-DWI）的单指数模型和双指数模型在鉴别食管鳞状细胞癌（ESCC）病理分级中的诊断效能。
54例ESCC患者分为低分化（PD）、中分化（MD）和高分化（WD）三组，行IVIM-DWI扫描。利用肿瘤的IVIM数据计算单指数（D、D和f）和双指数拟合参数（D、D和f）。采用单因素方差分析及后续检验比较三组的平均参数值。绘制鉴别ESCC病理分级的受试者工作特征曲线。分析病理分级与IVIM参数之间的相关性。
PD、MD和WD ESCC组之间的f和f存在显著差异（均p<0.05）。f分别为0.32±0.07、0.23±0.08和0.16±0.05，f分别为0.35±0.08、0.26±0.10和0.18±0.07。WD组和PD组之间的D存在显著差异（1.48±0.51×10⁻³mm²/s对1.05±0.44×10⁻³mm²/s，p<0.05），但WD组和MD组、MD组和PD组之间无显著差异（均p>0.05）。三组之间的D*、D和D*无显著差异（均p>0.05）。D、f和f在鉴别WD与PD ESCC中的曲线下面积（AUC）分别为0.764、0.961和0.932，灵敏度和特异度分别为92.9%和60%、92.9%和90%、85.7%和100%。f和f在鉴别MD与PD ESCC中的AUC分别为0.839和0.757，灵敏度和特异度分别为78.6%和80%、85.7%和70%。f和f在鉴别MD与WD ESCC中的AUC分别为0.746和0.740，灵敏度和特异度分别为65%和85%、80%和60%。病理分化分级与所有IVIM参数均相关（均p<0.05）。
在鉴别ESCC病理分级方面，单指数IVIM模型优于双指数IVIM模型，这可能是一种有前景的预测ESCC病理分级的成像方法。
