Magnetic resonance spectroscopy associations with clinicopathologic features of estrogen-dependent endometrial cancer

BACKGROUND: We studied the magnetic resonance spectroscopy (MRS) associations with clinicopathologic features of estrogen-dependent endometrial cancer (type I EC). METHODS: Totally 45 patients with type I EC who underwent preoperative multi-voxel MRS at 3.0 T were enrolled. The mean ratio of the Cho peak integral to the unsuppressed water peak integral (Cho/water) of the tumor was calculated. The Cho/water and apparent diffusion coefficient (ADC) of type I EC with and without local invasion, as well as with different levels of Ki-67 staining index (SI) (≤ 40% and > 40%), were compared. Correlation test was used to examine the relationship of Cho/water, as well as mean ADC, with Ki-67 SI, tumor stage, and tumor grade. RESULTS: The mean Cho/water of EC with Ki-67 SI ≤ 40% (2.28 ± 0.93) × 10(−3) was lower than that with Ki-67 SI > 40% (4.08 ± 1.00) × 10(−3) (P < 0.001). The mean Cho/water of EC with deep and superficial myometrial invasion was (3.41 ± 1.26) × 10(−3) and (2.43 ± 1.11) × 10(−3), respectively (P = 0.011). There was no significant difference in Cho/water between type I EC with and without cervical invasioin ([2.68 ± 1.00] × 10(−3) and [2.77 ± 1.28] × 10(−3), P = 0.866). The mean Cho/water of type I EC with and without lymph node metastasis was (4.02 ± 1.90) × 10(−3) and (2.60 ± 1.06) × 10(−3), respectively (P = 0.014). The Cho/water was positively correlated with the Ki-67 SI (r = 0.701, P < 0.001). There were no significant differences in ADC among groups (all P > 0.05). CONCLUSION: MRS is helpful for preoperative assessment of clinicopathological features of type I EC.