Wang Fang, Wang Yafei, Qi Lisha, Liang Jing, Xiao Ben-Heng, Zhang Chen, Wáng Yì Xiáng J, Ye Zhaoxiang
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin, Tianjin, China.
Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin, Tianjin, China.
Magn Reson Imaging. 2025 Apr;117:110324. doi: 10.1016/j.mri.2025.110324. Epub 2025 Jan 4.
This study aimed to investigate the feasibility of diffusion-derived vessel density (DDVD) in characterizing tumor microvasculature in endometrial carcinoma (EC), and to explore the correlations with Ki-67 proliferation status and histological type based on DDVD values.
There were in total 81 EC patients. There were 64 cases of non-aggressive histological type, and 17 cases of aggressive histological type. Ki-67 labeling index was low (<50 %) in 35 cases and high (≥50 %) in 46 cases. DDVD is calculated according to: DDVD = S/ROI - S/ROI, where S and S refer to the tissue signal when b is 0 or 20 s/mm. Intraclass correlation coefficient (ICC); two-tailed independent samples t-test and Mann-Whitney U test, and Receiver operating characteristic area under the curve (AUC) were applied for statistical analysis.
Endometrial carcinoma showed lower DDVD values (34.9 ± 21.2, au/pixel) compared with myometrium (65.3 ± 37.4, P < 0.001). Tumors with Ki-67 high-proliferation or aggressive histological type had higher DDVD values than those with Ki-67 low-proliferation (44.17 (median) vs. 16.08, P < 0.001]] or non-aggressive histological type (47.92 vs. 30.77, P = 0.002). DDVD ROC curve analysis shows AUC of 0.842 for distinguishing between Ki-67 low- and high-expression, and AUC of 0.771 for distinguishing between non-aggressive and aggressive histological types. DDVD > 32.9 and DDVD > 50.1 provided a specificity of 85 % for identifying Ki67 high expression (sensitivity 78.3 %) and histological aggressive type (sensitivity 47.1 %), respectively.
DDVD can act as an imaging marker reflecting Ki-67 proliferation and histological aggressiveness of EC, thus helping pretreatment risk assessment in EC.
本研究旨在探讨扩散衍生血管密度（DDVD）在表征子宫内膜癌（EC）肿瘤微血管方面的可行性，并基于DDVD值探索其与Ki-67增殖状态及组织学类型的相关性。
共有81例EC患者。其中非侵袭性组织学类型64例，侵袭性组织学类型17例。Ki-67标记指数低（<50%）的有35例，高（≥50%）的有46例。DDVD按以下公式计算：DDVD = S/ROI - S/ROI，其中S和S分别指b值为0或20 s/mm²时的组织信号。采用组内相关系数（ICC）、双尾独立样本t检验和曼-惠特尼U检验以及受试者操作特征曲线下面积（AUC）进行统计分析。
与子宫肌层相比，子宫内膜癌的DDVD值较低（34.9 ± 21.2，au/像素），子宫肌层为（65.3 ± 37.4，P < 0.001）。Ki-67高增殖或侵袭性组织学类型的肿瘤，其DDVD值高于Ki-67低增殖（中位数44.17对16.08，P < 0.001）或非侵袭性组织学类型（47.92对30.77，P = 0.002）的肿瘤。DDVD的ROC曲线分析显示，区分Ki-67低表达和高表达的AUC为0.842，区分非侵袭性和侵袭性组织学类型的AUC为0.771。DDVD > 32.9和DDVD > 50.1分别对识别Ki67高表达（敏感性78.3%）和组织学侵袭性类型（敏感性47.1%）具有85%的特异性。
DDVD可作为反映EC的Ki-67增殖和组织学侵袭性的影像标志物，有助于EC的术前风险评估。
