Quantitative dynamic contrast-enhanced parameters and intravoxel incoherent motion facilitate the prediction of TP53 status and risk stratification of early-stage endometrial carcinoma

作者：Hongxia Wang, Ruifang Yan, Zhong Li, Beiran Wang, Xingxing Jin, Zhenfang Guo, Wangyi Liu, Meng Zhang, Kaiyu Wang, Jinxia Guo, Dongming Han · 发表于：Radiology and Oncology · 年份：2023 · DOI：10.2478/raon-2023-0023 · 被引用次数：10 · 研究领域：Endometrial and Cervical Cancer Treatments、MRI in cancer diagnosis、Angiogenesis and VEGF in Cancer

Abstract Background The aim of the study was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion (IVIM) in differentiating TP53-mutant from wild type, low-risk from non-low-risk early-stage endometrial carcinoma (EC). Patients and methods A total of 74 EC patients underwent pelvic MRI. Parameters volume transfer constant (K trans ), rate transfer constant (K ep ), the volume of extravascular extracellular space per unit volume of tissue (V e ), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and microvascular volume fraction (f) were compared. The combination of parameters was investigated by logistic regression and evaluated by bootstrap (1000 samples), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results In the TP53-mutant group, K trans and K ep were higher and D was lower than in the TP53-wild group; K trans , V e , f, and D were lower in the non-low-risk group than in the low-risk group (all P < 0.05). In the identification of TP53-mutant and TP53-wild early-stage EC, K trans and D were independent predictors, and the combination of them had an optimal diagnostic efficacy (AUC, 0.867; sensitivity, 92.00%; specificity, 80.95%), which was significantly better than D (Z = 2.169, P = 0.030) and K trans (Z = 2.572, P = 0.010). In the identification of low-risk and non-low-risk early-stage EC, K trans , V e , and f were indepen...