Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China.
Department of Radiology, Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science & Technology, Jiang'an District Wuhan Hong Kong Road No.100, Wuhan, 430019, China.
Abdom Radiol (NY). 2023 Dec;48(12):3746-3756. doi: 10.1007/s00261-023-04041-6. Epub 2023 Sep 22.
To explore the value of Diffusion kurtosis imaging (DKI) with multiple quantitative parameters in predicting microsatellite instability (MSI) status in endometrial carcinoma (EC).
Data of 38 patients with EC were retrospectively analyzed, including 12 MSI and 26 microsatellite stability (MSS). All patients underwent preoperative 1.5T MR examination. The quantitative values of the DKI sequence in the tumor parenchyma of the two groups, including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), fractional anisotropy of kurtosis (FAk), mean diffusivity (MD), axial diffusivity (Da), and radial diffusivity (Dr) were measured by two observers, respectively.
The MK, Ka, Kr, FA, FAk, MD, Da, and Dr values of the MSI group were 1.074 ± 0.162, 1.253 ± 0.229, 0.886 ± 0.205, 0.207 ± 0.041, 0.397 ± 0.129, 0.890 ± 0.158 μm/ms, 1.083 ± 0.218 μm/ms, and 0.793 ± 0.133 μm/ms, and 0.956 (0.889,1.002), 1.048 ± 0.211, 0.831 ± 0.099, 0.188 ± 0.061, 0.334 (0.241,0.410), 1.043 ± 0.217 μm/ms, 1.235 ± 0.229 μm/ms, and 0.946 ± 0.215 μm/ms in the MSS group. The MK and Ka values of the MSI group were higher than those of the MSS group (P<0.05), while the MD and Dr values were lower than those of the MSS group (P<0.05). The AUC of MK, Ka, MD, and Dr values in predicting MSI status of EC was 0.763, 0.729, 0.731, 0.748, respectively. The sensitivity was 58.3%, 50.0%, 65.4%, 61.5%, and the specificity was 96.2%, 92.3%, 75.0%, 83.3%, respectively.
DKI can provide multiple quantitative parameters for predicting the MSI status of EC, and assist gynecologist to optimize the treatment plan for the patients.
探讨扩散峰度成像（DKI）多个定量参数在预测子宫内膜癌（EC）微卫星不稳定性（MSI）状态中的价值。
回顾性分析 38 例 EC 患者的资料，包括 12 例 MSI 和 26 例微卫星稳定（MSS）。所有患者均行术前 1.5T MR 检查。两位观察者分别测量两组肿瘤实质的 DKI 序列的定量值，包括平均峰度（MK）、轴向峰度（Ka）、径向峰度（Kr）、各向异性分数（FA）、峰度各向异性分数（FAk）、平均扩散系数（MD）、轴向扩散系数（Da）和径向扩散系数（Dr）。
MSI 组的 MK、Ka、Kr、FA、FAk、MD、Da 和 Dr 值分别为 1.074±0.162、1.253±0.229、0.886±0.205、0.207±0.041、0.397±0.129、0.890±0.158μm/ms、1.083±0.218μm/ms和 0.793±0.133μm/ms，0.956（0.889，1.002）、1.048±0.211、0.831±0.099、0.188±0.061、0.334（0.241，0.410）、1.043±0.217μm/ms、1.235±0.229μm/ms和 0.946±0.215μm/ms。MSI 组的 MK 和 Ka 值高于 MSS 组（P<0.05），而 MD 和 Dr 值低于 MSS 组（P<0.05）。MK、Ka、MD 和 Dr 值预测 EC 中 MSI 状态的 AUC 分别为 0.763、0.729、0.731、0.748。敏感度分别为 58.3%、50.0%、65.4%、61.5%，特异度分别为 96.2%、92.3%、75.0%、83.3%。
DKI 可为预测 EC 的 MSI 状态提供多个定量参数，协助妇科医生为患者制定更优的治疗方案。
