Comparative analysis of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in evaluating the histological grade of cervical squamous carcinoma

• Published in: BMC cancer Vol. 22; no. 1; p. 87
• Main Authors: Hou, Mengyan, Song, Kai, Ren, Jipeng, Wang, Kaiyu, Guo, Jinxia, Niu, Yongchao, Li, Zhenyu, Han, Dongming
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.01.2022; BioMed Central; BMC
• Subjects: Adult; Aged; Amide proton transfer-weighted imaging; Amides; Brain cancer; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Cervical cancer; Cervical squamous cell carcinoma; Cervix; Comparative analysis; Diagnosis; Diagnostic imaging; Diffusion coefficient; Diffusion kurtosis imaging; Diffusion Magnetic Resonance Imaging; Diffusion Tensor Imaging; Diffusion-weighted imaging; Female; Humans; Kurtosis; Magnetic resonance imaging; Methods; Middle Aged; Neoplasm Grading - methods; Normal distribution; Observer Variation; Pathology; Patients; Prospective Studies; Prostate; Protons; Reproducibility of Results; Software; Squamous cell carcinoma; Statistical analysis; Uterine cancer; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology; Uterus; Work stations; China; Diffusion-weighted imaging; Cervical squamous cell carcinoma; Amide proton transfer-weighted imaging; Diffusion kurtosis imaging
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-022-09205-z

Uterine cervical cancer (UCC) was the fourth leading cause of cancer death among women worldwide. The conventional MRI hardly revealing the microstructure information. This study aimed to compare the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in evaluating the histological grade of cervical squamous carcinoma (CSC) in addition to routine diffusion-weighted imaging (DWI). Forty-six patients with CSC underwent pelvic DKI and APTWI. The magnetization transfer ratio asymmetry (MTRasym), apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated and compared based on the histological grade. Correlation coefficients between each parameter and histological grade were calculated. The MTRasym and MK values of grade 1 (G1) were significantly lower than those of grade 2 (G2), and those parameters of G2 were significantly lower than those of grade 3 (G3). The MD and ADC values of G1 were significantly higher than those of G2, and those of G2 were significantly higher than those of G3. MTRasym and MK were both positively correlated with histological grade (r = 0.789 and 0.743, P <  0.001), while MD and ADC were both negatively correlated with histological grade (r = - 0.732 and - 0.644, P <  0.001). For the diagnosis of G1 and G2 CSCs, AUC (APTWI+DKI + DWI) > AUC (DKI + DWI) > AUC (APTWI+DKI) > AUC (APTWI+DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD) > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (DKI + DWI) and AUC (ADC) were significant. For the diagnosis of G2 and G3 CSCs, AUC (APTWI+DKI + DWI) > AUC (APTWI+DWI) > AUC (APTWI+DKI) > AUC (DKI + DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (APTWI+DWI) and AUC (ADC) were significant. Compared with DWI and DKI, APTWI is more effective in identifying the histological grades of CSC. APTWI is recommended as a supplementary scan to routine DWI in CSCs.