Li Yuan, Liu Xinyu, Wang Xiaoqi, Lin Chengyu, Qi Yafei, Chen Bo, Zhou Hailong, Wu Qiaoling, Ren Jing, Zhao Jia, Yang Junjun, Xiang Yang, He Yonglan, Jin Zhengyu, Xue Huadan
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China.
Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
Insights Imaging. 2021 Dec 11;12(1):182. doi: 10.1186/s13244-021-01126-y.
To investigate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging to differentiate mismatch repair deficient (dMMR) and mismatch repair proficient (pMMR) tumors in endometrioid endometrial adenocarcinoma (EEA).
Forty-nine patients with EEA underwent T1-weighted imaging, T2-weighted imaging, 3D APTw imaging, and diffusion-weighted imaging at 3 T MRI. Image quality and measurement confidence of APTw images were evaluated on a 5-point Likert scale. APTw and apparent diffusion coefficient (ADC) values were calculated and compared between the dMMR and pMMR groups and among the three EEA histologic grades based on the Federation of Gynecology and Obstetrics (FIGO) grading system criteria. Student's t-test, analysis of variance with Scheffe post hoc test, and receiver operating characteristic analysis were performed. Statistical significance was set at p < 0.05.
Thirty-five EEA patients (9 with dMMR tumors and 26 with pMMR tumors) with good image quality were enrolled in quantitative analysis. APTw values were significantly higher in the dMMR group than in the pMMR group (3.2 ± 0.3% and 2.8 ± 0.5%, respectively; p = 0.019). ADC values of the dMMR and pMMR groups were 0.874 ± 0.104 × 10 mm/s and 0.903 ± 0.100 × 10 mm/s, respectively. No significant between-group difference was noted (p = 0.476). No statistically significant differences were observed in APTw values or ADC values among the three histologic grades (p = 0.766 and p = 0.295, respectively).
APTw values may be used as potential imaging markers to differentiate dMMR from pMMR tumors in EEA.
探讨三维（3D）酰胺质子转移加权（APTw）成像在鉴别子宫内膜样腺癌（EEA）中错配修复缺陷（dMMR）和错配修复 proficient（pMMR）肿瘤中的应用价值。
49例EEA患者在3T磁共振成像（MRI）上接受了T1加权成像、T2加权成像、3D APTw成像和扩散加权成像。APTw图像的图像质量和测量置信度采用5分制Likert量表进行评估。根据妇科肿瘤联合会（FIGO）分级系统标准，计算并比较dMMR组和pMMR组以及三种EEA组织学分级之间的APTw和表观扩散系数（ADC）值。进行了学生t检验、Scheffe事后检验的方差分析和受试者操作特征分析。统计学显著性设定为p < 0.05。
35例图像质量良好的EEA患者（9例dMMR肿瘤患者和26例pMMR肿瘤患者）纳入定量分析。dMMR组的APTw值显著高于pMMR组（分别为3.2±0.3%和2.8±0.5%；p = 0.019）。dMMR组和pMMR组的ADC值分别为0.874±0.104×10 mm/s和0.903±0.100×10 mm/s。组间差异无统计学意义（p = 0.476）。三种组织学分级之间的APTw值或ADC值均未观察到统计学显著差异（分别为p = 0.766和p = 0.295）。
APTw值可作为鉴别EEA中dMMR和pMMR肿瘤的潜在成像标志物。
