Amin Mohamed Ibrahim, Amin A El-Aziz I, Badr Shimaa Elsayed, Ebaid Noha Yahia
Department of Diagnostic Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Gynecology and Obstetrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Pol J Radiol. 2024 Aug 5;89:e378-e385. doi: 10.5114/pjr/190840. eCollection 2024.
To evaluate the extent to which magnetic resonance spectroscopy (MRS) lipid metabolites are accurate in predicting high-grade cervical cancer.
This prospective single-centre pilot study included 20 cases with pathologically proven cervical cancer. They underwent pelvic magnetic resonance imaging (MRI) with MRS. Two radiologists, blinded to the histopathological results, with 10 years of experience in gynaecological imaging, independently analysed the MRI images and MRS curves, and a third one resolved any disagreement. Using the histopathological results as a standard test, the receiver operating characteristics (ROC) curve was utilised to calculate the optimal lipid peak (1.3 ppm) cutoff for predicting high-grade cervical cancer. The difference in MRS metabolites between low- and high-grade cervical cancer groups was estimated using the Mann-Whitney test.
The study included 11 high-grade and nine low-grade cervical cancer cases based on the histopathological evaluation. A lipid (1.3 ppm) peak of 29.9 was the optimal cutoff for predicting high-grade cervical cancer with 100% sensitivity, 77.8%, specificity, and 90% accuracy. Moreover, there was a significant difference between low- and high-grade cervical cancer cases concerning lipid peak at 0.9 ppm, lipid peak at 1.3 ppm, and the peak of choline with (-value 0.025, 0.001, and 0.023), respectively.
MRS might be considered a useful imaging technique for assessing the grade of cervical cancer and improving the planning of treatment. It shows a good diagnostic accuracy. Therefore, it can be adopted in clinical practice for better patient outcome.
评估磁共振波谱（MRS）脂质代谢物在预测高级别宫颈癌方面的准确程度。
这项前瞻性单中心试点研究纳入了20例经病理证实的宫颈癌病例。他们接受了盆腔磁共振成像（MRI）及MRS检查。两名对组织病理学结果不知情、具有10年妇科影像诊断经验的放射科医生独立分析MRI图像和MRS曲线，第三名医生解决任何分歧。以组织病理学结果作为标准测试，利用受试者操作特征（ROC）曲线计算预测高级别宫颈癌的最佳脂质峰（1.3 ppm）临界值。采用Mann-Whitney检验评估低级别和高级别宫颈癌组之间MRS代谢物的差异。
根据组织病理学评估，该研究纳入了11例高级别宫颈癌病例和9例低级别宫颈癌病例。脂质（1.3 ppm）峰为29.9是预测高级别宫颈癌的最佳临界值，灵敏度为100%，特异性为77.8%，准确性为90%。此外，低级别和高级别宫颈癌病例在0.9 ppm脂质峰、1.3 ppm脂质峰以及胆碱峰方面存在显著差异（P值分别为0.025、0.001和0.023）。
MRS可被视为评估宫颈癌分级和改善治疗方案规划的一种有用的成像技术。它显示出良好的诊断准确性。因此，可在临床实践中采用以获得更好的患者预后。
