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Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters
OBJECTIVES: To investigate the role of quantitative Magnetic Resonance Imaging (MRI) in preoperative assessment of tumour aggressiveness in patients with endometrial cancer, correlating multiple parameters obtained from diffusion and dynamic contrast-enhanced (DCE) MR sequences with conventional his...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Institute of Radiology.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9327771/ https://www.ncbi.nlm.nih.gov/pubmed/34111974 http://dx.doi.org/10.1259/bjr.20210054 |
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author | Satta, Serena Dolciami, Miriam Celli, Veronica Di Stadio, Francesca Perniola, Giorgia Palaia, Innocenza Pernazza, Angelina Della Rocca, Carlo Rizzo, Stefania Catalano, Carlo Capuani, Silvia Manganaro, Lucia |
author_facet | Satta, Serena Dolciami, Miriam Celli, Veronica Di Stadio, Francesca Perniola, Giorgia Palaia, Innocenza Pernazza, Angelina Della Rocca, Carlo Rizzo, Stefania Catalano, Carlo Capuani, Silvia Manganaro, Lucia |
author_sort | Satta, Serena |
collection | PubMed |
description | OBJECTIVES: To investigate the role of quantitative Magnetic Resonance Imaging (MRI) in preoperative assessment of tumour aggressiveness in patients with endometrial cancer, correlating multiple parameters obtained from diffusion and dynamic contrast-enhanced (DCE) MR sequences with conventional histopathological prognostic factors and inflammatory tumour infiltrate. METHODS: Forty-four patients with biopsy-proven endometrial cancer underwent preoperative MR imaging at 3T scanner, including DCE imaging, diffusion-weighted imaging (DWI) and intravoxel incoherent motion imaging (IVIM). Images were analysed on dedicated post-processing workstations and quantitative parameters were extracted: K(trans), K(ep), V(e) and AUC from the DCE; ADC from DWI; diffusion D, pseudo diffusion D*, perfusion fraction f from IVIM and tumour volume from DWI. The following histopathological data were obtained after surgery: histological type, grading (G), lympho-vascular invasion (LVI), lymph node status, FIGO stage and inflammatory infiltrate. RESULTS: ADC was significantly higher in endometrioid histology, G1-G2 (low grade), and stage IA. Significantly higher D* were found in endometrioid subptype, negative lymph nodes and stage IA. The absence of LVI is associated with higher f values. K(trans) and V(e) values were significantly higher in low grade. Higher D*, f and AUC occur with the presence of chronic inflammatory cells, D * was also able to distinguish chronic from mixed type of inflammation. Larger volume was significantly correlated with the presence of mixed-type inflammation, LVI, positive lymph nodes and stage ≥IB. CONCLUSIONS: Quantitative biomarkers obtained from pre-operative DWI, IVIM and DCE-MR examination are an in vivo representation of the physiological and microstructural characteristics of endometrial carcinoma allowing to obtain the fundamental parameters for stratification into Risk Classes. ADVANCES IN KNOWLEDGE: Quantitative imaging biomarkers obtained from DWI, DCE and IVIM may improve preoperative prognostic stratification in patients with endometrial cancer leading to a more informed therapeutic choice. |
format | Online Article Text |
id | pubmed-9327771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The British Institute of Radiology. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93277712022-08-05 Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters Satta, Serena Dolciami, Miriam Celli, Veronica Di Stadio, Francesca Perniola, Giorgia Palaia, Innocenza Pernazza, Angelina Della Rocca, Carlo Rizzo, Stefania Catalano, Carlo Capuani, Silvia Manganaro, Lucia Br J Radiol Female genitourinary oncology special feature: Full Paper OBJECTIVES: To investigate the role of quantitative Magnetic Resonance Imaging (MRI) in preoperative assessment of tumour aggressiveness in patients with endometrial cancer, correlating multiple parameters obtained from diffusion and dynamic contrast-enhanced (DCE) MR sequences with conventional histopathological prognostic factors and inflammatory tumour infiltrate. METHODS: Forty-four patients with biopsy-proven endometrial cancer underwent preoperative MR imaging at 3T scanner, including DCE imaging, diffusion-weighted imaging (DWI) and intravoxel incoherent motion imaging (IVIM). Images were analysed on dedicated post-processing workstations and quantitative parameters were extracted: K(trans), K(ep), V(e) and AUC from the DCE; ADC from DWI; diffusion D, pseudo diffusion D*, perfusion fraction f from IVIM and tumour volume from DWI. The following histopathological data were obtained after surgery: histological type, grading (G), lympho-vascular invasion (LVI), lymph node status, FIGO stage and inflammatory infiltrate. RESULTS: ADC was significantly higher in endometrioid histology, G1-G2 (low grade), and stage IA. Significantly higher D* were found in endometrioid subptype, negative lymph nodes and stage IA. The absence of LVI is associated with higher f values. K(trans) and V(e) values were significantly higher in low grade. Higher D*, f and AUC occur with the presence of chronic inflammatory cells, D * was also able to distinguish chronic from mixed type of inflammation. Larger volume was significantly correlated with the presence of mixed-type inflammation, LVI, positive lymph nodes and stage ≥IB. CONCLUSIONS: Quantitative biomarkers obtained from pre-operative DWI, IVIM and DCE-MR examination are an in vivo representation of the physiological and microstructural characteristics of endometrial carcinoma allowing to obtain the fundamental parameters for stratification into Risk Classes. ADVANCES IN KNOWLEDGE: Quantitative imaging biomarkers obtained from DWI, DCE and IVIM may improve preoperative prognostic stratification in patients with endometrial cancer leading to a more informed therapeutic choice. The British Institute of Radiology. 2021-09-01 2021-06-16 /pmc/articles/PMC9327771/ /pubmed/34111974 http://dx.doi.org/10.1259/bjr.20210054 Text en © 2021 The Authors. Published by the British Institute of Radiology https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/ (https://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 | Female genitourinary oncology special feature: Full Paper Satta, Serena Dolciami, Miriam Celli, Veronica Di Stadio, Francesca Perniola, Giorgia Palaia, Innocenza Pernazza, Angelina Della Rocca, Carlo Rizzo, Stefania Catalano, Carlo Capuani, Silvia Manganaro, Lucia Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title | Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title_full | Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title_fullStr | Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title_full_unstemmed | Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title_short | Quantitative diffusion and perfusion MRI in the evaluation of endometrial cancer: validation with histopathological parameters |
title_sort | quantitative diffusion and perfusion mri in the evaluation of endometrial cancer: validation with histopathological parameters |
topic | Female genitourinary oncology special feature: Full Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9327771/ https://www.ncbi.nlm.nih.gov/pubmed/34111974 http://dx.doi.org/10.1259/bjr.20210054 |
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