Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, 450052, Zhengzhou, Henan, China.
MR Collaboration, Siemens Healthcare Ltd, Beijing, China.
BMC Med Imaging. 2024 Jan 10;24(1):16. doi: 10.1186/s12880-024-01191-x.
T1 mapping can potentially quantitatively assess the intrinsic properties of tumors. This study was conducted to explore the ability of T1 mapping in distinguishing cervical cancer type, grade, and stage and compare the diagnostic performance of T1 mapping with diffusion kurtosis imaging (DKI).
One hundred fifty-seven patients with pathologically confirmed cervical cancer were enrolled in this prospectively study. T1 mapping and DKI were performed. The native T1, difference between native and postcontrast T1 (T1diff), mean kurtosis (MK), mean diffusivity (MD), and apparent diffusion coefficient (ADC) were calculated. Cervical squamous cell carcinoma (CSCC) and adenocarcinoma (CAC), low- and high-grade carcinomas, and early- and advanced-stage groups were compared using area under the receiver operating characteristic (AUROC) curves.
The native T1 and MK were higher, and the MD and ADC were lower for CSCC than for CAC (all p < 0.05). Compared with low-grade CSCC, high-grade CSCC had decreased T1, MD, ADC, and increased MK (p < 0.05). Compared with low-grade CAC, high-grade CAC had decreased T1 and increased MK (p < 0.05). Native T1 was significantly higher in the advanced-stage group than in the early-stage group (p < 0.05). The AUROC curves of native T1, MK, ADC and MD were 0,772, 0.731, 0.715, and 0.627, respectively, for distinguishing CSCC from CAC. The AUROC values were 0.762 between high- and low-grade CSCC and 0.835 between high- and low-grade CAC, with T1 and MK showing the best discriminative values, respectively. For distinguishing between advanced-stage and early-stage cervical cancer, only the AUROC of native T1 was statistically significant (AUROC = 0.651, p = 0.002).
Compared with DKI-derived parameters, native T1 exhibits better efficacy for identifying cervical cancer subtype and stage, and T1 exhibits comparable discriminative value for cervical cancer grade.
T1 映射技术可以定量评估肿瘤的固有特性。本研究旨在探讨 T1 映射在鉴别宫颈癌类型、分级和分期方面的能力，并比较 T1 映射与扩散峰度成像（DKI）的诊断性能。
本前瞻性研究纳入了 157 例经病理证实的宫颈癌患者。对所有患者均行 T1 映射和 DKI 检查。测量并计算 T1 弛豫时间、对比前后 T1 值的差值（T1diff）、平均峰度（MK）、平均弥散系数（MD）和表观弥散系数（ADC）。采用受试者工作特征（ROC）曲线下面积（AUROC）比较宫颈鳞癌（CSCC）和腺癌（CAC）、低级别和高级别癌、早期和晚期组之间的差异。
CSCC 的 T1 值和 MK 高于 CAC，MD 和 ADC 低于 CAC（均 P<0.05）。与低级别 CSCC 相比，高级别 CSCC 的 T1、MD、ADC 降低，MK 增加（均 P<0.05）。与低级别 CAC 相比，高级别 CAC 的 T1 降低，MK 增加（均 P<0.05）。与早期相比，晚期宫颈癌的 T1 值明显升高（P<0.05）。T1、MK、ADC 和 MD 鉴别 CSCC 和 CAC 的 AUROC 曲线分别为 0.772、0.731、0.715 和 0.627。鉴别 CSCC 高、低级别病变的 AUROC 值分别为 0.762 和 0.835，T1 和 MK 的鉴别效果最好。鉴别宫颈癌高、低级别病变时，仅 T1 值的 AUROC 有统计学意义（AUROC=0.762，P=0.002）。
与 DKI 衍生参数相比，T1 值在鉴别宫颈癌亚型和分期方面具有更好的效能，T1 值在鉴别宫颈癌分级方面具有相当的鉴别价值。
