Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Obstetrics and Gynecology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Magn Reson Imaging. 2024 Jul;60(1):67-77. doi: 10.1002/jmri.29106. Epub 2023 Oct 27.
Oscillating gradient diffusion-weighted imaging (DWI) enables elucidation of microstructural characteristics in cancers; however, there are limited data to evaluate its utility in patients with endometrial cancer.
To investigate the utility of oscillating gradient DWI for risk stratification in patients with uterine endometrial cancer compared with conventional pulsed gradient DWI.
Retrospective.
Sixty-three women (mean age: 58 [range: 32-85] years) with endometrial cancer.
FIELD STRENGTH/SEQUENCE: 3 T MRI including DWI using oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) research sequences.
Mean value of the apparent diffusion coefficient (ADC) values for OGSE (ADC) and PGSE (ADC) as well as the ADC ratio (ADC/ADC) within endometrial cancer were measured using regions of interest. Prognostic factors (histological grade, deep myometrial invasion, lymphovascular invasion, International Federation of Gynecology and Obstetrics [FIGO] stage, and prognostic risk classification) were tabulated.
Interobserver agreement was analyzed by calculating the intraclass correlation coefficient. The associations of ADC, ADC, and ADC/ADC with prognostic factors were examined using the Kendall rank correlation coefficient, Mann-Whitney U test, and receiver operating characteristic (ROC) curve. A P value of <0.05 was statistically significant.
Compared with ADC and ADC, ADC/ADC was significantly and strongly correlated with histological grade (observer 1, τ = 0.563; observer 2, τ = 0.456), FIGO stage (observer 1, τ = 0.354; observer 2, τ = 0.324), and prognostic risk classification (observer 1, τ = 0.456; observer 2, τ = 0.385). The area under the ROC curves of ADC/ADC for histological grade (observer 1, 0.92, 95% confidence intervals [CIs]: 0.83-0.98; observer 2, 0.84, 95% CI: 0.73-0.92) and prognostic risk (observer 1, 0.80, 95% CI: 0.68-0.89; observer 2, 0.76, 95% CI: 0.63-0.86) were significantly higher than that of ADC and ADC.
The ADC ratio obtained via oscillating gradient and pulsed gradient DWIs might be useful imaging biomarkers for risk stratification in patients with endometrial cancer.
3 TECHNICAL EFFICACY: Stage 2.
震荡梯度弥散加权成像（DWI）能够阐明癌症中的微观结构特征；然而，目前仅有有限的数据可用于评估其在子宫内膜癌患者中的应用价值。
研究在子宫内膜癌患者中，与常规脉冲梯度 DWI 相比，震荡梯度 DWI 用于风险分层的效用。
回顾性。
63 名女性（平均年龄：58 岁[范围：32-85 岁]），患有子宫内膜癌。
磁场强度/序列：3T MRI 包括使用震荡梯度自旋回波（OGSE）和脉冲梯度自旋回波（PGSE）研究序列进行 DWI。
通过使用感兴趣区测量 OGSE（ADC）和 PGSE（ADC）的表观扩散系数（ADC）值的平均值以及 ADC 比值（ADC/ADC）。列出了预后因素（组织学分级、深层肌层浸润、脉管侵犯、国际妇产科联合会[FIGO]分期和预后风险分类）。
通过计算组内相关系数来分析观察者间的一致性。使用 Kendall 秩相关系数、Mann-Whitney U 检验和受试者工作特征（ROC）曲线检查 ADC、ADC 和 ADC/ADC 与预后因素之间的关联。P 值<0.05 为统计学显著。
与 ADC 和 ADC 相比，ADC/ADC 与组织学分级（观察者 1，τ=0.563；观察者 2，τ=0.456）、FIGO 分期（观察者 1，τ=0.354；观察者 2，τ=0.324）和预后风险分类（观察者 1，τ=0.456；观察者 2，τ=0.385）具有显著且较强的相关性。ADC/ADC 的 ROC 曲线下面积对于组织学分级（观察者 1，0.92，95%置信区间[CI]：0.83-0.98；观察者 2，0.84，95%CI：0.73-0.92）和预后风险（观察者 1，0.80，95%CI：0.68-0.89；观察者 2，0.76，95%CI：0.63-0.86）的评估显著高于 ADC 和 ADC。
通过震荡梯度和脉冲梯度 DWI 获得的 ADC 比值可能是子宫内膜癌患者风险分层的有用影像学生物标志物。
3 级
2 级
