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Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study

OBJECTIVES: To evaluate the interobserver reliability and value of diffusional kurtosis imaging (DKI) in the assessment of uterine tumors compared with those of conventional diffusion-weighted imaging (DWI). METHODS: This retrospective study was approved by our institutional review board, which waiv...

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Autores principales: Dia, Aliou Amadou, Hori, Masatoshi, Onishi, Hiromitsu, Sakane, Makoto, Ota, Takashi, Tsuboyama, Takahiro, Tatsumi, Mitsuaki, Okuaki, Tomoyuki, Tomiyama, Noriyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703480/
https://www.ncbi.nlm.nih.gov/pubmed/29176867
http://dx.doi.org/10.1371/journal.pone.0188434
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author Dia, Aliou Amadou
Hori, Masatoshi
Onishi, Hiromitsu
Sakane, Makoto
Ota, Takashi
Tsuboyama, Takahiro
Tatsumi, Mitsuaki
Okuaki, Tomoyuki
Tomiyama, Noriyuki
author_facet Dia, Aliou Amadou
Hori, Masatoshi
Onishi, Hiromitsu
Sakane, Makoto
Ota, Takashi
Tsuboyama, Takahiro
Tatsumi, Mitsuaki
Okuaki, Tomoyuki
Tomiyama, Noriyuki
author_sort Dia, Aliou Amadou
collection PubMed
description OBJECTIVES: To evaluate the interobserver reliability and value of diffusional kurtosis imaging (DKI) in the assessment of uterine tumors compared with those of conventional diffusion-weighted imaging (DWI). METHODS: This retrospective study was approved by our institutional review board, which waived the requirement for informed consent. Fifty-eight women (mean age: 55.0 ± 13.6 years; range: 30–89 years) with suspected malignant uterine tumors underwent 3-T magnetic resonance imaging using DKI and DWI. Twelve had coexisting leiomyoma. Two observers analyzed region-of-interest measurements of diffusivity (D), kurtosis (K), and the apparent diffusion coefficient (ADC) of uterine lesions and healthy adjacent tissues. Interobserver agreement was evaluated using the intra-class correlation coefficient (ICC). The mean values were compared using one-way analysis of variance with a post-hoc Tukey’s honestly significant difference test. The diagnostic accuracy of D and ADC in differentiating malignant tumors from benign leiomyomas was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The ICCs between the two observers in evaluating D, K, and the ADC of the malignant tumors were higher than 0.84, suggesting excellent interobserver agreements. The mean D (×10(−3) mm(2)/s) of uterine cancers (1.05 ± 0.41 and 1.09 ± 0.40 for observers 1 and 2, respectively) were significantly lower than those of leiomyoma (1.40 ± 0.37 and 1.56 ± 0.33, respectively; P < 0.05), healthy myometrium (1.72 ± 0.27 and 1.69 ± 0.30, respectively; P < 0.001), and healthy endometrium (1.53 ± 0.35 and 1.42 ± 0.37, respectively; P < 0.005). There was no significant difference in the area under the ROC curve between D and ADC. The mean K of uterine cancers (0.88 ± 0.28 and 0.90 ± 0.23, respectively) were higher than those of myometrium (0.72 ± 0.10 and 0.73 ± 0.10, respectively; P < 0.001), healthy endometrium (0.65 ± 0.13 and 0.60 ± 0.18, respectively; P < 0.001), and leiomyoma (0.76 ± 0.14 and 0.77 ± 0.16, respectively; not significant, P > 0.1). CONCLUSIONS: Interobserver agreements in evaluating D, K, and ADC were moderate to excellent. D performed equally to conventional DWI in differentiating between benign and malignant uterine lesions. The mean K of malignant uterine lesions was significantly higher than that of non-tumorous myometrium or endometrium.
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spelling pubmed-57034802017-12-08 Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study Dia, Aliou Amadou Hori, Masatoshi Onishi, Hiromitsu Sakane, Makoto Ota, Takashi Tsuboyama, Takahiro Tatsumi, Mitsuaki Okuaki, Tomoyuki Tomiyama, Noriyuki PLoS One Research Article OBJECTIVES: To evaluate the interobserver reliability and value of diffusional kurtosis imaging (DKI) in the assessment of uterine tumors compared with those of conventional diffusion-weighted imaging (DWI). METHODS: This retrospective study was approved by our institutional review board, which waived the requirement for informed consent. Fifty-eight women (mean age: 55.0 ± 13.6 years; range: 30–89 years) with suspected malignant uterine tumors underwent 3-T magnetic resonance imaging using DKI and DWI. Twelve had coexisting leiomyoma. Two observers analyzed region-of-interest measurements of diffusivity (D), kurtosis (K), and the apparent diffusion coefficient (ADC) of uterine lesions and healthy adjacent tissues. Interobserver agreement was evaluated using the intra-class correlation coefficient (ICC). The mean values were compared using one-way analysis of variance with a post-hoc Tukey’s honestly significant difference test. The diagnostic accuracy of D and ADC in differentiating malignant tumors from benign leiomyomas was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The ICCs between the two observers in evaluating D, K, and the ADC of the malignant tumors were higher than 0.84, suggesting excellent interobserver agreements. The mean D (×10(−3) mm(2)/s) of uterine cancers (1.05 ± 0.41 and 1.09 ± 0.40 for observers 1 and 2, respectively) were significantly lower than those of leiomyoma (1.40 ± 0.37 and 1.56 ± 0.33, respectively; P < 0.05), healthy myometrium (1.72 ± 0.27 and 1.69 ± 0.30, respectively; P < 0.001), and healthy endometrium (1.53 ± 0.35 and 1.42 ± 0.37, respectively; P < 0.005). There was no significant difference in the area under the ROC curve between D and ADC. The mean K of uterine cancers (0.88 ± 0.28 and 0.90 ± 0.23, respectively) were higher than those of myometrium (0.72 ± 0.10 and 0.73 ± 0.10, respectively; P < 0.001), healthy endometrium (0.65 ± 0.13 and 0.60 ± 0.18, respectively; P < 0.001), and leiomyoma (0.76 ± 0.14 and 0.77 ± 0.16, respectively; not significant, P > 0.1). CONCLUSIONS: Interobserver agreements in evaluating D, K, and ADC were moderate to excellent. D performed equally to conventional DWI in differentiating between benign and malignant uterine lesions. The mean K of malignant uterine lesions was significantly higher than that of non-tumorous myometrium or endometrium. Public Library of Science 2017-11-27 /pmc/articles/PMC5703480/ /pubmed/29176867 http://dx.doi.org/10.1371/journal.pone.0188434 Text en © 2017 Dia et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dia, Aliou Amadou
Hori, Masatoshi
Onishi, Hiromitsu
Sakane, Makoto
Ota, Takashi
Tsuboyama, Takahiro
Tatsumi, Mitsuaki
Okuaki, Tomoyuki
Tomiyama, Noriyuki
Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title_full Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title_fullStr Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title_full_unstemmed Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title_short Application of non-Gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: A preliminary study
title_sort application of non-gaussian water diffusional kurtosis imaging in the assessment of uterine tumors: a preliminary study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703480/
https://www.ncbi.nlm.nih.gov/pubmed/29176867
http://dx.doi.org/10.1371/journal.pone.0188434
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