Wu LiFang, Ding LuoBing, Lin YanTao, Ou YangLin, Chen Yi, Tang YiLin, Lin Yang
Department of Radiology, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou 363000, China.
Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou 363000, China.
Magn Reson Imaging. 2025 Nov;123:110490. doi: 10.1016/j.mri.2025.110490. Epub 2025 Aug 8.
To investigate the utility of amide proton transfer (APT) imaging in conjunction with diffusion-weighted imaging (DWI) for distinguishing between benign and malignant soft tissue tumors (STTs), and to assess the correlation with Ki-67 expression.
A retrospective analysis was performed on 67 patients with soft tissue tumors. According to the pathological findings, the cohort was categorized into 39 cases of benign tumors and 28 cases of malignant tumors. ALL patients underwent APT imaging and DWI examinations, APT and Apparent diffusion coefficient (ADC) values were measured. Independent sample t-tests were used to compare the ADC and APT values between two groups. Receiver operating characteristic (ROC) curves were used to assess the sensitivity, specificity, and area under the curve (AUC) of APT, ADC, and the combination of ADC + APT in distinguishing benign and malignant tumors. The Delong test was employed to compare the diagnostic performance among these measures. Additionally, Spearman's correlation analysis was used to examine the relationship between APT, ADC and Ki-67 expression.
The APT values of malignant groups were significantly higher than benign groups (3.32 ± 0.93 % vs. 1.87 ± 0.99 %; P < 0.01). The ADC values of malignant groups were significantly lower than benign groups (1.08 ± 0.55 × 10 mm/s vs. 1.67 ± 0.54 × 10 mm/s; P < 0.01). The ROC analysis showed that the AUC values of APT, ADC, and APT+ADC in distinguishing benign and malignant tumors were 0.855, 0.795, and 0.911 respectively. The Spearman's correlation analysis showed that APT and ADC values were significantly correlated with Ki-67 expression，and the correlation coefficients were 0.501 and -0.526, respectively.
The APT imaging and DWI can effectively differentiate between benign and malignant STTs. Combining these techniques enhances diagnostic efficiency. Furthermore, APT and ADC values show a significant correlation with tumor Ki-67 levels, which provides a robust basis for predicting STTs aggressiveness.
探讨酰胺质子转移（APT）成像联合扩散加权成像（DWI）在鉴别良恶性软组织肿瘤（STT）中的应用价值，并评估其与Ki-67表达的相关性。
对67例软组织肿瘤患者进行回顾性分析。根据病理结果，将研究对象分为良性肿瘤39例和恶性肿瘤28例。所有患者均接受APT成像和DWI检查，并测量APT值和表观扩散系数（ADC）值。采用独立样本t检验比较两组间的ADC值和APT值。采用受试者操作特征（ROC）曲线评估APT、ADC以及ADC+APT联合诊断在鉴别良恶性肿瘤中的敏感性、特异性和曲线下面积（AUC）。采用德龙检验比较这些指标的诊断性能。此外，采用Spearman相关性分析来研究APT、ADC与Ki-67表达之间的关系。
恶性组的APT值显著高于良性组（3.32±0.93% vs. 1.87±0.99%；P<0.01）。恶性组的ADC值显著低于良性组（1.08±0.55×10⁻³mm²/s vs. 1.67±0.54×10⁻³mm²/s；P<0.01）。ROC分析显示，APT、ADC以及APT+ADC在鉴别良恶性肿瘤中的AUC值分别为0.855、0.795和0.911。Spearman相关性分析显示，APT值和ADC值与Ki-67表达显著相关，相关系数分别为0.501和-0.526。
APT成像和DWI能够有效鉴别良恶性STT。联合应用这些技术可提高诊断效率。此外，APT值和ADC值与肿瘤Ki-67水平显著相关，为预测STT的侵袭性提供了有力依据。
