Wang Wei, Fan Xiaofei, Yang Jie, Wang Xuemei, Gu Yu, Chen Mingxin, Jiang Yueluan, Liu Lin, Zhang Mengchao
Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
J Magn Reson Imaging. 2023 Feb;57(2):587-597. doi: 10.1002/jmri.28423. Epub 2022 Sep 12.
Lymphovascular space invasion (LVSI) is a risk factor for poor prognosis of cervical cancer. Preoperative identification of LVSI is very difficult.
To evaluate the potential of extracellular volume (ECV) fraction based on T1 mapping in preoperative identification of LVSI in cervical cancer compared with dynamic contrast-enhanced MRI (DCE-MRI).
Retrospective.
A total of 79 patients (median age 54 years) with cervical cancer were classified into LVSI group (n = 29) and without LVSI group (n = 50) according to postoperative pathology.
FIELD STRENGTH/SEQUENCE: A 3-T, noncontrast and contrast-enhanced T1 mapping performed with volume interpolated breath hold examination (VIBE) sequence, DCE-MRI applied with 3D T1-weighted VIBE sequence.
Regions of interest along the medial edge of the lesion were drawn on slices depicting the maximum cross-section of the tumor. The noncontrast and contrast-enhanced T1 value of the tumor and arteries in the same slice were measured, and ECV was calculated from T1 values. The parametric maps (K , k , and v ) derived from DCE-MRI standard Toft's model were evaluated.
ECV, K , k , and v between groups with and without LVSI were compared using Student's t-test. The receiver operating characteristic (ROC) curve and DeLong test were used to evaluate and compare the diagnostic performance of ECV, K , k , and v for differentiating LVSI. P < 0.05 was considered statistically significant.
The ECV and K of the LVSI group were significantly higher than that of non-LVSI group (52.86% vs. 36.77%, 0.239 vs. 0.176, respectively), and no significant differences in K or v values were observed (P = 0.071 and P = 0.168, respectively). The ECV fraction showed significantly higher area under ROC curve than K for differentiating LVSI (0.874 vs. 0.655, respectively).
ECV measurements based on T1 mapping might improve the discrimination between patients with and without LVSI in cervical cancer, showing better performance for this purpose than DCE-MRI.
2 TECHNICAL EFFICACY: Stage 2.
淋巴管血管间隙浸润（LVSI）是宫颈癌预后不良的一个危险因素。术前识别LVSI非常困难。
与动态对比增强磁共振成像（DCE-MRI）相比，评估基于T1映射的细胞外容积（ECV）分数在术前识别宫颈癌LVSI中的潜力。
回顾性研究。
根据术后病理将79例宫颈癌患者（中位年龄54岁）分为LVSI组（n = 29）和无LVSI组（n = 50）。
场强/序列：采用容积内插屏气检查（VIBE）序列进行3-T非对比和对比增强T1映射，采用3D T1加权VIBE序列进行DCE-MRI检查。
在描绘肿瘤最大横截面的切片上，沿着病变内侧边缘绘制感兴趣区。测量同一切片中肿瘤和动脉的非对比和对比增强T1值，并根据T1值计算ECV。评估源自DCE-MRI标准Toft模型的参数图（K、k和v）。
采用Student t检验比较有和无LVSI组之间的ECV、K、k和v。采用受试者操作特征（ROC）曲线和DeLong检验评估和比较ECV、K、k和v对区分LVSI的诊断性能。P < 0.05被认为具有统计学意义。
LVSI组的ECV和K显著高于无LVSI组（分别为52.86%对36.77%，0.239对0.176），而K或v值未观察到显著差异（分别为P = 0.071和P = 0.168）。在区分LVSI方面，ECV分数的ROC曲线下面积显著高于K（分别为0.874对0.655）。
基于T1映射的ECV测量可能会改善宫颈癌中有和无LVSI患者之间的鉴别，在此方面比DCE-MRI表现更好。
2 技术效能：2级
