Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, P.R. China.
Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, P.R. China.
Curr Med Imaging. 2024;20:e15734056289592. doi: 10.2174/0115734056289592240408061811.
Endometrial Cancer (EC) is a highly heterogeneous cancer comprising both histological and molecular subtypes. Using a non-invasive modality method to trigger these subtypes as early as possible can aid clinicians in establishing individualized treatment.
The study aimed to clarify the value of the Apparent Diffusion Coefficient (ADC) of EC MRI in determining molecular subtypes.
We retrospectively recruited 109 patients with pathologically proven EC (78 endometrioid cancers and 31 non-endometrioid cancers) with available molecular classification from a tertiary centre. MRI was prospectively performed a month prior to surgery; images were blindly interpreted by two experienced radiologists with consensus reading. The ADC value was measured by an experienced radiologist on the commercially available processing workstation. Interoperator measurement consistency was calculated.
Our sample comprised 17 PLOE, 32 MSI-H, 31 NSMP, and 29 P53abn ECs. Clinical information did not differ significantly among the groups. The maximum diameter and volume of the lesions differed among the groups. The ADC value in the maximal area (ADCarea) or region of interest (ROI, ADCroi) in the P53abn group was higher than that in the other groups (894.0 ±12.6 and 817.5 ± 83.3 x10-6 mm2/s). The ADC mean values were significantly different between the P53abn group and the other groups (P = 0.000). The nomogram showed the highest discriminative ability to distinguish P53abn EC from other types (AUC: 0.859).
Our results have suggested the quantitative MR characteristics (ADC values) derived from preoperative EC MRI to provide useful information in preoperatively determining P53abn cancer.
子宫内膜癌（EC）是一种高度异质性的癌症，包括组织学和分子亚型。使用非侵入性方法尽早触发这些亚型可以帮助临床医生制定个体化治疗方案。
本研究旨在阐明 EC MRI 的表观扩散系数（ADC）在确定分子亚型方面的价值。
我们回顾性招募了 109 名经病理证实的 EC 患者（78 例子宫内膜样癌和 31 例非子宫内膜样癌），这些患者均来自一家三级中心，并且具有可获得的分子分类。MRI 是在手术前一个月进行的前瞻性检查；由两名具有共识阅读经验的资深放射科医生对图像进行盲法解读。由一位有经验的放射科医生在商业上可用的处理工作站上测量 ADC 值。计算了操作者之间的测量一致性。
我们的样本包括 17 例 PLOE、32 例 MSI-H、31 例 NSMP 和 29 例 P53abn EC。组间的临床信息无显著差异。组间病变的最大直径和体积存在差异。P53abn 组的最大面积（ADCarea）或感兴趣区（ROI，ADCroi）的 ADC 值高于其他组（894.0±12.6 和 817.5±83.3 x10-6 mm2/s）。P53abn 组与其他组之间的 ADC 平均值存在显著差异（P=0.000）。列线图显示了区分 P53abn EC 与其他类型的最高判别能力（AUC：0.859）。
我们的结果表明，术前 EC MRI 得出的定量 MR 特征（ADC 值）可提供有用的信息，有助于术前确定 P53abn 癌症。
