Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
NMR Biomed. 2023 Aug;36(8):e4918. doi: 10.1002/nbm.4918. Epub 2023 Apr 3.
To evaluate the clinical feasibility of T mapping and extracellular volume fraction (ECV) measurement in assessing prognostic factors in patients with cervical squamous cell carcinoma (CSCC).
A total of 117 CSCC patients and 59 healthy volunteers underwent T mapping and diffusion-weighted imaging (DWI) on a 3 T system. Native T , contrast-enhanced T , ECV, and apparent diffusion coefficient (ADC) were calculated and compared based on surgico-pathologically verified deep stromal infiltration, parametrial invasion (PMI), lymphovascular space invasion (LVSI), lymph node metastasis, stage, histologic grade, and the Ki-67 labeling index (LI).
Native T , contrast-enhanced T , ECV, and ADC values were significantly different between CSCC and the normal cervix (all p < 0.05). No significant differences were observed in any parameters of CSCC when the tumors were grouped by stromal infiltration or lymph node status, respectively (all p > 0.05). In subgroups of the tumor stage and PMI, native T was significantly higher for advanced-stage (p = 0.032) and PMI-positive CSCC (p = 0.001). In subgroups of the grade and Ki-67 LI, contrast-enhanced T was significantly higher for high-grade (p = 0.012) and Ki-67 LI ≥ 50% tumors (p = 0.027). ECV was significantly higher in LVSI-positive CSCC than in LVSI-negative CSCC (p < 0.001). ADC values showed a significant difference for the grade (p < 0.001) but none for the other subgroups.
Both T mapping and DWI could stratify the CSCC histologic grade. In addition, T mapping and ECV measurement might provide more quantitative metrics for noninvasively predicting poor prognostic factors and aiding in preoperative risk assessment in CSCC patients.
评估 T 映射和细胞外体积分数（ECV）测量在评估宫颈鳞状细胞癌（CSCC）患者预后因素中的临床可行性。
共对 117 例 CSCC 患者和 59 例健康志愿者在 3T 系统上进行 T 映射和弥散加权成像（DWI）检查。基于手术病理证实的深层间质浸润、宫旁浸润（PMI）、脉管间隙浸润（LVSI）、淋巴结转移、分期、组织学分级和 Ki-67 标记指数（LI），计算并比较了固有 T、对比增强 T、ECV 和表观扩散系数（ADC）。
CSCC 与正常宫颈之间的固有 T、对比增强 T、ECV 和 ADC 值均有显著差异（均 P<0.05）。当肿瘤分别按间质浸润或淋巴结状态分组时，CSCC 的任何参数均无显著差异（均 P>0.05）。在肿瘤分期和 PMI 的亚组中，晚期 CSCC 的固有 T 值明显升高（P=0.032），PMI 阳性 CSCC 的固有 T 值明显升高（P=0.001）。在分级和 Ki-67 LI 的亚组中，高级别 CSCC 的对比增强 T 值明显较高（P=0.012），Ki-67 LI≥50%的肿瘤对比增强 T 值明显较高（P=0.027）。LVSI 阳性 CSCC 的 ECV 值明显高于 LVSI 阴性 CSCC（P<0.001）。ADC 值在分级方面有显著差异（P<0.001），但在其他亚组中无差异。
T 映射和 DWI 均可对 CSCC 组织学分级进行分层。此外，T 映射和 ECV 测量可能为预测 CSCC 患者不良预后因素和辅助术前风险评估提供更多定量指标。
