Amide Proton Transfer‐Weighted Imaging and Multiple Models Diffusion‐Weighted Imaging Facilitates Preoperative Risk Stratification of Early‐Stage Endometrial Carcinoma

作者：Nan Meng, Ting Fang, Pengyang Feng, Zhun Huang, Jing Sun, Xuejia Wang, Jie Shang, Kaiyu Wang, Dongming Han, Meiyun Wang · 发表于：Journal of Magnetic Resonance Imaging · 年份：2021 · DOI：10.1002/jmri.27684 · 被引用次数：41 · 研究领域：MRI in cancer diagnosis、Lanthanide and Transition Metal Complexes、Endometrial and Cervical Cancer Treatments

BACKGROUND: Endometrial carcinoma (EC) risk stratification is generally based on histological assessment. It would be beneficial to perform risk stratification noninvasively by MRI. PURPOSE: To investigate the application of amide proton transfer-weighted imaging (APTWI), monoexponential, biexponential, and stretched exponential intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) for the evaluation of risk stratification in early-stage EC. STUDY TYPE: Prospective. POPULATION: Eighty patients with early-stage EC (47 classified as low risk, 20 as medium risk, and 13 as high risk by histological grade and International Federation of Gynecology and Obstetrics stage). FIELD STRENGTH/SEQUENCE: T1-weighted imaging, T2-weighted imaging, IVIM, APTWI, and DKI MRI at 3 T. ASSESSMENT: The magnetization transfer ratio asymmetry (MTRasym [3.5 ppm]), apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), water molecular diffusion heterogeneity index (α), mean kurtosis (MK), and mean diffusivity (MD) were calculated and compared between low-risk and non-low-risk groups. STATISTICAL TESTS: Individual sample t test, analysis of variance, and logistic regression. A P-value <0.05 was considered statistically significant. RESULTS: The α, ADC, D, DDC, and MD were significantly higher and the f, MK, and MTRasym (3.5 ppm) were significantly lower in the low-risk group t...