Xie Zongyuan, Lin Liangjie, Ma Changjun, Liu Ailian
Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of MRI, North China University of Science and Technology Affiliated Hospital, Tangshan, China.
Front Oncol. 2024 Dec 11;14:1439229. doi: 10.3389/fonc.2024.1439229. eCollection 2024.
To explore the value of quantitative imaging parameters by enhanced T weighted angiography (ESWAN) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for evaluating the expression of Hypoxia-inducible factor-1α (HIF-1α) in endometrial carcinoma (EC).
Data from 122 patients with EC confirmed by clinical pathology were retrospectively analyzed. According to the number of positive cells stained with HIF-1α by immunohistochemistry, patients were divided into two groups: 65 cases with high expression of HIF-1α and 57 cases with low expression of HIF-1α. Clinical data included age, FIGO stage, menopausal status, abnormal uterine bleeding, and pathological type. All patients underwent preoperative 1.5T MRI scans, including ESWAN and DCE-MRI. The amplitude, phase, and R values derived from ESWAN and the volume transfer constant (K), rate constant (K), and extravascular volume fraction (V) values derived from DCE-MRI were measured by two observers, respectively. The intra-class correlation coefficient (ICC) was used to assess the measurement of reproducibility across observers, and the differences in imaging parameters between the two groups were compared using the independent sample t-test or Mann-Whitney U-test. Binary logistic regression analysis was used to find independent risk factors for HIF-1α expression. The efficacy of selected imaging parameters for predicting HIF-1α expression was assessed using receiver operating characteristic (ROC) curves, and the Delong test was used to compare the area under ROC curves (AUC).
The consistency between the two observers was good (ICC>0.75). The R , K, and K values of the HIF-1α high expression group were higher than those of the HIF-1α low expression group (14.59 ± 4.06 . 11.99 ± 2.84 Hz, 0.45 ± 0.18 . 0.36 ± 0.14/min, and 2.17 ± 1.10 . 1.54 ± 0.80/min) (< 0.001, = 0.011, and =0.001). Binary logistic regression analysis revealed that R and K values were independent risk factors for HIF-1α expression. The AUC values of R , K, and their combination for prediction of HIF-1α expression were 0.697, 0.677, and 0.781, respectively. The diagnostic efficacy was significantly improved with combination of R and K.
Quantitative parameters by ESWAN and DCE-MRI showed significant differences between EC patients with low and high expression of HIF-1α, and the combination of ESWAN and DCE-MRI improves the efficacy in prediction of HIF-1α expression in EC, which has an excellent clinical application prospect.
探讨增强T加权血管造影（ESWAN）和动态对比增强磁共振成像（DCE-MRI）的定量成像参数在评估子宫内膜癌（EC）中缺氧诱导因子-1α（HIF-1α）表达方面的价值。
回顾性分析122例经临床病理确诊的EC患者的数据。根据免疫组织化学法检测HIF-1α染色阳性细胞数量，将患者分为两组：HIF-1α高表达组65例和HIF-1α低表达组57例。临床资料包括年龄、国际妇产科联盟（FIGO）分期、绝经状态、子宫异常出血及病理类型。所有患者术前行1.5T MRI扫描，包括ESWAN和DCE-MRI。由两名观察者分别测量ESWAN得出的幅度、相位和R值以及DCE-MRI得出的容积转运常数（K）、速率常数（K）和血管外容积分数（V）值。组内相关系数（ICC）用于评估观察者间测量的可重复性，两组间成像参数差异采用独立样本t检验或曼-惠特尼U检验进行比较。采用二元逻辑回归分析寻找HIF-1α表达的独立危险因素。使用受试者工作特征（ROC）曲线评估所选成像参数预测HIF-1α表达的效能，采用德龙检验比较ROC曲线下面积（AUC）。
两名观察者之间的一致性良好（ICC>0.75）。HIF-1α高表达组的R、K和K值高于HIF-1α低表达组（分别为14.59±4.06、11.99±2.84 Hz，0.45±0.18、0.36±0.14/min，以及2.17±1.10、1.54±0.80/min）（<0.001，=0.011，以及=0.001）。二元逻辑回归分析显示R和K值是HIF-1α表达的独立危险因素。R、K及其联合预测HIF-1α表达的AUC值分别为0.697、0.677和0.781。R和K联合使用时诊断效能显著提高。
ESWAN和DCE-MRI的定量参数在HIF-1α低表达和高表达的EC患者之间显示出显著差异，ESWAN和DCE-MRI联合使用可提高预测EC中HIF-1α表达的效能，具有良好的临床应用前景。
