Assessment of Cervical Cancer with a Parameter-Free Intravoxel Incoherent Motion Imaging Algorithm.
10.3348/kjr.2017.18.3.510
- Author:
Anton S BECKER
1
;
Jose A PERUCHO
;
Moritz C WURNIG
;
Andreas BOSS
;
Soleen GHAFOOR
;
Pek Lan KHONG
;
Elaine Y P LEE
Author Information
1. Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich 8091, Switzerland. anton.becker@usz.ch
- Publication Type:Original Article
- Keywords:
Uterine cervical cancer;
MRI;
Diffusion MRI;
Perfusion imaging;
Technology assessment
- MeSH:
Adenocarcinoma;
Biopsy;
Carcinoma, Squamous Cell;
Diffusion;
Diffusion Magnetic Resonance Imaging;
Epithelial Cells;
Ethics Committees, Research;
Female;
Humans;
Magnetic Resonance Imaging;
Perfusion;
Perfusion Imaging;
Prospective Studies;
Technology Assessment, Biomedical;
Uterine Cervical Neoplasms*
- From:Korean Journal of Radiology
2017;18(3):510-518
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the feasibility of a parameter-free intravoxel incoherent motion (IVIM) approach in cervical cancer, to assess the optimal b-value threshold, and to preliminarily examine differences in the derived perfusion and diffusion parameters for different histological cancer types. MATERIALS AND METHODS: After Institutional Review Board approval, 19 female patients (mean age, 54 years; age range, 37–78 years) gave consent and were enrolled in this prospective magnetic resonance imaging study. Clinical staging and biopsy results were obtained. Echo-planar diffusion weighted sequences at 13 b-values were acquired at 3 tesla field strength. Single-sliced region-of-interest IVIM analysis with adaptive b-value thresholds was applied to each tumor, yielding the optimal fit and the optimal parameters for pseudodiffusion (D*), perfusion fraction (F(p)) and diffusion coefficient (D). Monoexponential apparent diffusion coefficient (ADC) was calculated for comparison with D. RESULTS: Biopsy revealed squamous cell carcinoma in 10 patients and adenocarcinoma in 9. The b-value threshold (median [interquartile range]) depended on the histological type and was 35 (22.5–50) s/mm² in squamous cell carcinoma and 150 (100–150) s/mm² in adenocarcinoma (p < 0.05). Comparing squamous cell vs. adenocarcinoma, D* (45.1 [25.1–60.4] × 10⁻³ mm²/s vs. 12.4 [10.5–21.2] × 10⁻³ mm²/s) and F(p) (7.5% [7.0–9.0%] vs. 9.9% [9.0–11.4%]) differed significantly between the subtypes (p < 0.02), whereas D did not (0.89 [0.75–0.94] × 10⁻³ mm²/s vs. 0.90 [0.82–0.97] × 10⁻³ mm²/s, p = 0.27). The residuals did not differ (0.74 [0.60–0.92] vs. 0.94 [0.67–1.01], p = 0.32). The ADC systematically underestimated the magnitude of diffusion restriction compared to D (p < 0.001). CONCLUSION: The parameter-free IVIM approach is feasible in cervical cancer. The b-value threshold and perfusion-related parameters depend on the tumor histology type.
