Yuan Junhui, Xie Deshun, Fang Shaobo, Meng Fan, Wu Yue, Shan Dongqiu, Shao Nannan, Wang Bangmin, Tian Zhichao, Wang Yuanyuan, Xu Chunmiao, Chen Xuejun
Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
Department of Radiology, Heze Municipal Hospital, Heze, Shandong, China.
Insights Imaging. 2024 Jun 13;15(1):142. doi: 10.1186/s13244-024-01687-8.
To investigate the correlation between MRI findings and histological features for preoperative prediction of histological grading and Ki-67 expression level in alveolar soft part sarcoma (ASPS).
A retrospective analysis was conducted on 63 ASPS patients (Jan 2017-May 2023). All patients underwent 3.0-T MRI examinations, including conventional sequences, dynamic contrast-enhanced scans with time-intensity curve analysis, and diffusion-weighted imaging with apparent diffusion coefficient (ADC) measurements. Patients were divided into low-grade (histological Grade I) and high-grade (histological Grade II/III) groups based on pathology. Immunohistochemistry was used to assess Ki-67 expression levels in ASPS. Statistical analysis included chi-square tests, Wilcoxon rank-sum test, binary logistic regression analysis, Spearman correlation analysis, and receiver operating characteristic curve analysis of various observational data.
There were 29 low-grade and 34 high-grade patients (26 males and 37 females) and a wide age range (5-68 years). Distant metastasis, tumor enhancement characteristics, and ADC values were independent predictors of high-grade ASPS. High-grade ASPS had lower ADC values (p = 0.002), with an area under the curve (AUC), sensitivity, and specificity of 0.723, 79.4%, and 58.6%, respectively, for high-grade prediction. There was a negative correlation between ADC values and Ki-67 expression (r = -0.526; p < 0.001). When the cut-off value of ADC was 0.997 × 10 mm²/s, the AUC, sensitivity, and specificity for predicting high Ki-67 expression were 0.805, 65.6%, and 83.9%, respectively.
Qualitative and quantitative MRI parameters are valuable for predicting histological grading and Ki-67 expression levels in ASPS.
This study will help provide a more nuanced understanding of ASPS and guide personalized treatment strategies.
There is limited research on assessing ASPS prognosis through MRI. Metastasis, enhancement, and ADC correlated with histological grade; ADC related to Ki-67 expression. MRI provides clinicians with valuable information on ASPS grading and proliferation activity.
探讨MRI表现与组织学特征之间的相关性，以术前预测肺泡软组织肉瘤（ASPS）的组织学分级和Ki-67表达水平。
对63例ASPS患者（2017年1月至2023年5月）进行回顾性分析。所有患者均接受3.0-T MRI检查，包括常规序列、采用时间-强度曲线分析的动态对比增强扫描以及测量表观扩散系数（ADC）的扩散加权成像。根据病理结果将患者分为低级别（组织学I级）和高级别（组织学II/III级）组。采用免疫组织化学法评估ASPS中Ki-67的表达水平。统计分析包括对各种观察数据进行卡方检验、Wilcoxon秩和检验、二元逻辑回归分析、Spearman相关性分析以及受试者工作特征曲线分析。
低级别患者29例，高级别患者34例（男性26例，女性37例），年龄范围较广（5至68岁）。远处转移、肿瘤强化特征和ADC值是高级别ASPS的独立预测因素。高级别ASPS的ADC值较低（p = 0.002），对于高级别预测，曲线下面积（AUC）、敏感度和特异度分别为0.723、79.4%和58.6%。ADC值与Ki-67表达呈负相关（r = -0.526；p < 0.001）。当ADC的截断值为0.997×10⁻³mm²/s时，预测高Ki-67表达的AUC、敏感度和特异度分别为0.805、65.6%和83.9%。
定性和定量的MRI参数对于预测ASPS的组织学分级和Ki-67表达水平具有重要价值。
本研究将有助于更细致地了解ASPS并指导个性化治疗策略。
通过MRI评估ASPS预后的研究有限。转移、强化和ADC与组织学分级相关；ADC与Ki-67表达相关。MRI为临床医生提供了有关ASPS分级和增殖活性的有价值信息。
