Title:Value of Multimodal Diffusion-weighted Imaging in Preoperative Evaluation of
Ki-67 Expression in Endometrial Carcinoma
Volume: 20
Author(s): Huan Meng, Si-Xuan Ding, Yu Zhang, Feng-Ying Zhu, Jing Wang, Jia-Ning Wang*, Bu-Lang Gao*Xiao-Ping Yin*
Affiliation:
- Hebei Key Laboratory of Precise Imaging of Inflammation Related Tumors, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
- Department of Radiology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
- Department of Radiology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China
Keywords:
Endometrial carcinoma, Ki-67 expression, Diffusion weighted imaging, Multimodal, Efficiency, intravoxel incoherent motion.
Abstract:
Purpose:
To investigate the value of multimodal diffusion weighted imaging (DWI) in preoperative evaluation of Ki-67 expression of endometrial
carcinoma (EC).
Materials and Methods:
Patients who had undergone pelvic DWI, intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) sequence MRI scan before
surgery were retrospectively enrolled. Single index model, double index model, and DKI were used for post-processing of the DWI data, and the
apparent diffusion coefficient (ADC), real diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), non-Gaussian mean
diffusion kurtosis (MK), mean diffusion coefficient (MD) and anisotropy fraction (FA) were calculated and compared between the Ki-67 high
(≥50%) and low (<50%) expression groups.
Results:
Forty-two patients with a median age of 56 (range 37 - 75) years were enrolled, including 15 patients with a high Ki-67 (≥50%) expression and 27
with a low Ki-67 (<50%) expression. The MK (0.91 ± 0.12 vs. 0.76 ± 0.12) was significantly (P<0.05) higher while MD (0.99 ± 0.17 vs. 1.16 ±
0.22), D (0.55 ± 0.06 vs. 0.62 ± 0.08), and f (0.21 vs. 0.28) were significantly (P<0.05) lower in the high than in the low expression group. The
combined model of MK, MD, D, and f-values had the largest area under the curve (AUC) value of 0.869 (95% CI: 0.764-0.974), sensitivity 0.733
and specificity 0.852, followed by the MK value with an AUC value 0.827 (95% CI: 0.700-0.954), sensitivity 0.733 and specificity 0.815.
Conclusions:
IVIM and DKI have certain diagnostic values for preoperative evaluation of the EC Ki-67 expression, and the combined model has the highest
diagnostic efficiency.
