Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio

• Published in: European radiology 2018-05, Vol.28 (5), p.1875-1883
• Main Authors: Li, Xiangsheng, Wang, Ping, Li, Dechang, Zhu, Hongxian, Meng, Limin, Song, Yunlong, Xie, Lizhi, Zhu, Jianping, Yu, Tao
• Format: Article
• Language: English
• Subjects: Adult; Cervical cancer; Cervical carcinoma; Cervix; Cervix Uteri - pathology; Contrast Media - pharmacokinetics; Diagnosis, Differential; Diagnostic Radiology; Diffusion Magnetic Resonance Imaging - methods; Early Diagnosis; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic resonance imaging; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging - methods; Neuroradiology; Patients; Quality; Radiology; Regression analysis; ROC Curve; Solid tumors; Statistical analysis; Stroma; Tumors; Ultrasound; Uterine Cervical Neoplasms - diagnosis
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-5183-3

Objectives To investigate if intravoxel incoherent motion (IVIM) MR imaging can predict the tumour-stroma ratio (TSR) in patients with early cervical carcinoma. Methods Fifty-four patients with early cervical carcinoma were prospectively enrolled into this study. All patients underwent IVIM imaging and parameters including D, D* and f value were measured. The tumours were classified into stroma-rich and stroma-poor group according to TSR, and comparisons of IVIM parameters between two groups were performed. The relationships between IVIM parameters and TSR were analysed by using a multivariate multi-regression analysis. Results D and f values were significantly lower in stroma-poor tumours than in stroma-rich tumours ( p =0.02, 0.04), while the difference in D* value between two groups didn't achieve statistical significance ( p =0.09). The areas under ROC curves of D and f values in discriminating stroma-rich and stroma-poor tumours were 0.835 (95%CI=0.616~0.905) and 0.686 (95%CI=0.575~0.798). In multiple linear regression analysis , D value, pathologic type, histologic grade, tumour size and f value were independently correlated with TSR of cervical carcinoma. Conclusions D and f values are independently correlated with TSR of cervical carcinoma and have the potential for quantitative measurement of TSR. Key Points • TSR is a recognized independent prognostic factor in many solid tumours. • D and f values measured by IVIM MRI are independently correlated with TSR while D* is not. • IVIM offers the potential to predict TSR.