Soft tissue sarcomas: IVIM and DKI correlate with the expression of HIF-1α on direct comparison of MRI and pathological slices

• Published in: European radiology 2021-07, Vol.31 (7), p.4669-4679
• Main Authors: Li, Xiangwen, Yang, Lin, Wang, Qimeng, Tao, Juan, Pan, Ziang, Wang, Shaowu
• Format: Article
• Language: English
• Subjects: Chi-square test; Control methods; Correlation; Diagnostic Radiology; Diffusion coefficient; Hypoxia-inducible factor 1a; Imaging; Informed consent; Internal Medicine; Interventional Radiology; Kurtosis; Magnetic resonance imaging; Medicine; Medicine & Public Health; Musculoskeletal; Neuroradiology; Parameters; Pathology; Perfusion; Radiology; Sarcoma; Soft tissue sarcoma; Soft tissues; Statistical tests; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-020-07526-w

Objective To investigate the correlation of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters with the expression of HIF-1α in soft tissue sarcoma (STS). Methods This prospective study was approved by the institutional ethics committee. Written informed consent was obtained from all patients. Forty patients with STS who underwent 3.0 T MRI, including IVIM and DKI, were included in the study. Standard apparent diffusion coefficient (ADC), true ADC ( D slow ), pseudo ADC ( D fast ), perfusion fraction ( f ), mean kurtosis (MK), and mean diffusivity (MD) of each lesion were independently analyzed by two observers. An MRI-pathology control method was used to ensure correspondence between the MRI slices and the pathological sections. Spearman analysis, independent sample t test, Mann-Whitney U test, chi-squared test, and receiver operating characteristic (ROC) curve analysis were performed. Results D slow and MD values showed a negative correlation with HIF-1α expression ( r = − 0.469, − 0.588). MK and f values showed a positive correlation with HIF-1α expression ( r = 0.779, 0.572). D slow , MD, MK, and f values showed significant differences between the high- and low-expression groups. The MK value showed the best diagnostic ability. The optimal cut-off MK value of 0.604 was associated with 78.3% sensitivity and 88.2% specificity (area under the curve, 0.867). Conclusions This preliminary study demonstrated the association of IVIM and DKI parameters with the expression of HIF-1α in STS. Key Points • IVIM and DKI parameters are correlated with the expression of HIF-1α in STS. • The MRI-pathology control method can be used in clinical studies to ensure correspondence between MRI slices and pathology sections.