Du Lianze, Yuan Qinghai, Zhang Mengdi, Ma Rui, Zhu Lili, Han Qinghe
Department of Radiology, The Second Hospital of Jilin University, Changchun, China.
Quant Imaging Med Surg. 2024 Aug 1;14(8):5803-5813. doi: 10.21037/qims-24-412. Epub 2024 Jul 26.
Parametrial infiltration (PMI) is an important indicator for staging and treatment of cervical cancer (CC). The potential of amide proton transfer-weighted (APTw) parameters of peritumor tissue in predicting PMI is still uncertain. This study aims to explore whether the APTw parameters of peritumor tissue can improve diagnostic value of diffusion-weighted imaging (DWI) in magnetic resonance imaging (MRI).
Eighty-one patients with pathologic analysis-confirmed CC were enrolled in this retrospective study. All patients underwent APTw MRI and DWI. The APTw values of tumor (APTw-t), APTw values in peritumor tissues (APTw-p) and apparent diffusion coefficient (ADC) values were independently reviewed by two radiologists to map the regions of interest and measure the corresponding values. Receiver operating characteristic curves were generated to evaluate the diagnostic performance of these quantitative parameters.
The study patients were divided into the PMI group (n=22) and non-PMI group (n=59). The APTw-t and APTw-p values (%) of PMI group were higher than those of the non-PMI group [3.71 (interquartile range, IQR, 3.60-3.98) and 2.75 (IQR, 2.68-2.77) 3.33 (IQR, 3.24-3.60) and 1.98 (IQR, 1.82-2.36); P<0.001]. The ADC values of PMI group were lower than those of non-PMI group [0.88 (IQR, 0.83-0.94) ×10 0.95 (IQR, 0.88-1.04)×10 mm/sec; P<0.001]. The area under the curve (AUC) of APTw-t, APTw-p and ADC value for PMI diagnosis were 0.810, 0.831 and 0.806 respectively. In addition, the AUC value (0.918) of APTw-p + ADC was optimal, with a sensitivity and specificity of 91.20% and 87.20% respectively.
APTw in peritumor tissues, combined with ADC value can be used to efficiently distinguish PMI of CC.
宫旁浸润（PMI）是宫颈癌（CC）分期和治疗的重要指标。肿瘤周围组织的酰胺质子转移加权（APTw）参数预测PMI的潜力仍不确定。本研究旨在探讨肿瘤周围组织的APTw参数是否能提高磁共振成像（MRI）中扩散加权成像（DWI）的诊断价值。
81例经病理分析确诊为CC的患者纳入本回顾性研究。所有患者均接受APTw MRI和DWI检查。由两名放射科医生独立评估肿瘤的APTw值（APTw-t）、肿瘤周围组织的APTw值（APTw-p）和表观扩散系数（ADC）值，以绘制感兴趣区域并测量相应值。生成受试者操作特征曲线以评估这些定量参数的诊断性能。
研究患者分为PMI组（n = 22）和非PMI组（n = 59）。PMI组的APTw-t和APTw-p值（%）高于非PMI组[3.71（四分位数间距，IQR，3.60 - 3.98）和2.75（IQR，2.68 - 2.77）对3.33（IQR，3.24 - 3.60）和1.98（IQR，1.82 - 2.36）；P < 0.001]。PMI组的ADC值低于非PMI组[0.88（IQR，0.83 - 0.94）×10对0.95（IQR，0.88 - 1.04）×10 mm²/sec；P < 0.001]。APTw-t、APTw-p和ADC值对PMI诊断的曲线下面积（AUC）分别为0.810、0.831和0.806。此外，APTw-p + ADC的AUC值（0.918）最佳，灵敏度和特异度分别为91.20%和87.20%。
肿瘤周围组织的APTw联合ADC值可有效区分CC的PMI。
