Beibei Li1, Hongzan Sun2, Siyu Zhang1, Xiaoqi Wang3, Qiyong Guo1. 1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, PR China. 2. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, PR China. Electronic address: sunhongzan@126.com. 3. Philips Healthcare, 7F, Tower No. 2, The World Profit Centre, No.16 Tianze Road, Chaoyang District, Beijing 100600, PR China.
Abstract
PURPOSE: This study aimed to investigate whether amide proton transfer (APT) imaging, compared with intravoxel incoherent motion (IVIM) imaging-derived parameters, can differentiate squamous cell carcinoma of the cervix (SCCC) from the normal cervical stroma and distinguish poorly differentiated SCCC from well-moderately differentiated SCCC. METHODS: This prospective study enrolled 32 patients, comprising 20 patients with well-moderately differentiated SCCC and 12 patients with poorly differentiated SCCC. 20 healthy volunteers were enrolled as a control group. A bi-exponential model (BEM) analysis was performed to derive ADC, pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). The APT signal intensity (APT SI), ADC, D, D* and f were measured. The parameters between the groups were compared with independent t-tests. Diagnostic performance was evaluated with a ROC analysis. RESULTS: The APT SI of SCCC (2.92 ± 0.24%) was higher than that of normal cervical stroma (2.72 ± 0.36%) with P = 0.020. The comparison of the AUCs for the diagnosis of SCCC was ADC > f > APT SI > D* > D. A significant difference was found in the APT SI between the well-moderately differentiated SCCC group (2.82 ± 0.15%) and the poorly differentiated SCCC group (3.09 ± 0.27%) with P = 0.006. Except for D (P = 0.012), the ADC, D* and f values were not significantly different between the groups (P > 0.05). The comparison of the AUCs for distinguishing poorly differentiated SCCC was APT SI > D > ADC > D* = f. CONCLUSION: APT imaging may be a useful technique in the diagnosis and predicting the differentiation of SCCC.
PURPOSE: This study aimed to investigate whether amide proton transfer (APT) imaging, compared with intravoxel incoherent motion (IVIM) imaging-derived parameters, can differentiate squamous cell carcinoma of the cervix (SCCC) from the normal cervical stroma and distinguish poorly differentiated SCCC from well-moderately differentiated SCCC. METHODS: This prospective study enrolled 32 patients, comprising 20 patients with well-moderately differentiated SCCC and 12 patients with poorly differentiated SCCC. 20 healthy volunteers were enrolled as a control group. A bi-exponential model (BEM) analysis was performed to derive ADC, pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). The APT signal intensity (APT SI), ADC, D, D* and f were measured. The parameters between the groups were compared with independent t-tests. Diagnostic performance was evaluated with a ROC analysis. RESULTS: The APT SI of SCCC (2.92 ± 0.24%) was higher than that of normal cervical stroma (2.72 ± 0.36%) with P = 0.020. The comparison of the AUCs for the diagnosis of SCCC was ADC > f > APT SI > D* > D. A significant difference was found in the APT SI between the well-moderately differentiated SCCC group (2.82 ± 0.15%) and the poorly differentiated SCCC group (3.09 ± 0.27%) with P = 0.006. Except for D (P = 0.012), the ADC, D* and f values were not significantly different between the groups (P > 0.05). The comparison of the AUCs for distinguishing poorly differentiated SCCC was APT SI > D > ADC > D* = f. CONCLUSION: APT imaging may be a useful technique in the diagnosis and predicting the differentiation of SCCC.