Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, China.
Philips (China) Investment Co. Ltd Building A1, No 718, Ling Shi Road, Jing'an District, Shanghai, China.
Eur J Radiol. 2024 Sep;178:111622. doi: 10.1016/j.ejrad.2024.111622. Epub 2024 Jul 14.
To investigate the value of microstructural characteristics derived from time-dependent diffusion MRI in distinguishing high-grade serous ovarian cancer (HGSOC) from serous borderline ovarian tumor (SBOT) and the associations of immunohistochemical markers with microstructural features.
Totally 34 HGSOC and 12 SBOT cases who received preoperative pelvic MRI were retrospectively included in this study. Two radiologists delineated the tumors to obtain the regions of interest (ROIs). Time-dependent diffusion MRI signals were fitted by the IMPULSED (imaging microstructural parameters using limited spectrally edited diffusion) model, to extract microstructural parameters, including fraction of the intracellular component (f), cell diameter (d), cellularity and extracellular diffusivity (D). Apparent diffusion coefficient (ADC) values were obtained from standard diffusion-weighted imaging (DWI). The parameters of HGSOCs and SBOTs were compared, and the diagnostic performance was evaluated. The associations of microstructural indexes with immunopathological parameters were assessed, including Ki-67, P53, Pax-8, ER and PR.
In this study, f, cellularity, D and ADC had good diagnostic performance levels in differentiating HGSOC from SBOT, with AUCs of 0.936, 0.909, 0.902 and 0.914, respectively. There were no significant differences in diagnostic performance among these parameters. Spearman analysis revealed in the HGSOC group, cellularity had a significant positive correlation with P53 expression (P = 0.028, r = 0.389) and D had a significant positive correlation with Pax-8 expression (P = 0.018, r = 0.415). ICC showed excellent agreement for all parameters.
Time-dependent diffusion MRI had value in evaluating the microstructures of HGSOC and SBOT and could discriminate between these tumors.
探讨时相关扩散 MRI 衍生的微观结构特征在鉴别高级别浆液性卵巢癌（HGSOC）与浆液性交界性卵巢肿瘤（SBOT）中的价值，并研究免疫组织化学标志物与微观结构特征的相关性。
回顾性纳入了 34 例 HGSOC 和 12 例 SBOT 患者，这些患者均接受了盆腔术前 MRI 检查。两位放射科医生勾画肿瘤以获取感兴趣区（ROI）。采用 IMPULSED（通过有限光谱编辑扩散成像来获取微观结构参数）模型拟合时相关扩散 MRI 信号，以提取微观结构参数，包括细胞内成分分数（f）、细胞直径（d）、细胞密度和细胞外弥散度（D）。从标准弥散加权成像（DWI）中获得表观弥散系数（ADC）值。比较 HGSOC 和 SBOT 的参数，并评估诊断性能。评估微观结构指标与 Ki-67、P53、Pax-8、ER 和 PR 等免疫病理参数的相关性。
本研究中，f、细胞密度、D 和 ADC 在鉴别 HGSOC 与 SBOT 方面具有较好的诊断性能，AUC 分别为 0.936、0.909、0.902 和 0.914。这些参数之间的诊断性能无显著差异。Spearman 分析显示，在 HGSOC 组中，细胞密度与 P53 表达呈显著正相关（P=0.028，r=0.389），D 与 Pax-8 表达呈显著正相关（P=0.018，r=0.415）。ICC 显示所有参数的一致性均很好。
时相关扩散 MRI 对评估 HGSOC 和 SBOT 的微观结构具有一定价值，可用于鉴别这两种肿瘤。
