Abdominal radiology (New York) · 2021
Feasibility of intravoxel incoherent motion diffusion-weighted imaging in distinguishing adenocarcinoma originated from uterine corpus or cervix.
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Zhang Qi, Ouyang Han, Ye Feng, Song Ying, Xie Lizhi, Zhao Xinming, Yu Xiaoduo
Аннотация
PURPOSE: To prospectively assess the incremental value of intravoxel incoherent motion (IVIM) DWI in determining whether the adenocarcinoma originated from the uterine corpus or cervix.
METHODS: Eighty consecutive uterine adenocarcinomas from the cervix or endometrium confirmed by histopathology underwent IVIM DWI acquisition on a 3.0T MR scanner before treatment. Five morphologic features were analyzed using Fisher exact test; IVIM DWI-derived parameters, including apparent diffusion coefficient (ADC), true coefficient diffusivity (D), perfusion-related diffusivity (D*), and perfusion fraction (f) were compared using two-sample independent t-test or Mann-Whitney U test. Logistic regression analysis was used to develop different diagnosis model. The ROCs of these variables and diagnostic models were compared to evaluate the diagnostic efficiency.
RESULTS: Among single morphologic features, tumor location yielded the highest AUC of 0.891 in distinguishing endometrial adenocarcinoma (EAC) from cervical adenocarcinoma (CAC). Among single IVIM DWI-derived parameters, f values showed the best diagnostic performance (AUC: 0.837) at the optimal cut-off value of 0.261. Additionally, the combined diagnostic model, which consisted of tumor location, ADC and f showed the largest AUC of 0.967 with the highest sensitivity of 88.14%, highest specificity of 100.00%, and highest accuracy of 91.25%.
CONCLUSION: IVIM DWI-derived parameters add additional diagnostic value to conventional morphologic features. A combined diagnosis model is a promising imaging tool for predicting the origin of uterine adenocarcinoma, further contributing to therapeutic decision-making.
METHODS: Eighty consecutive uterine adenocarcinomas from the cervix or endometrium confirmed by histopathology underwent IVIM DWI acquisition on a 3.0T MR scanner before treatment. Five morphologic features were analyzed using Fisher exact test; IVIM DWI-derived parameters, including apparent diffusion coefficient (ADC), true coefficient diffusivity (D), perfusion-related diffusivity (D*), and perfusion fraction (f) were compared using two-sample independent t-test or Mann-Whitney U test. Logistic regression analysis was used to develop different diagnosis model. The ROCs of these variables and diagnostic models were compared to evaluate the diagnostic efficiency.
RESULTS: Among single morphologic features, tumor location yielded the highest AUC of 0.891 in distinguishing endometrial adenocarcinoma (EAC) from cervical adenocarcinoma (CAC). Among single IVIM DWI-derived parameters, f values showed the best diagnostic performance (AUC: 0.837) at the optimal cut-off value of 0.261. Additionally, the combined diagnostic model, which consisted of tumor location, ADC and f showed the largest AUC of 0.967 with the highest sensitivity of 88.14%, highest specificity of 100.00%, and highest accuracy of 91.25%.
CONCLUSION: IVIM DWI-derived parameters add additional diagnostic value to conventional morphologic features. A combined diagnosis model is a promising imaging tool for predicting the origin of uterine adenocarcinoma, further contributing to therapeutic decision-making.