The value of diffusion-weighted imaging (DWI) combined with serum beta-human chorionic gonadotropin (β-hCG) in evaluating the proliferative activity of chorionic trophoblasts in early tubal pregnancy.

Aim: To assess the predictive value of diffusion-weighted imaging (DWI) in combination with beta-human chorionic gonadotropin (β-hCG) for determining the proliferative activity of trophoblastic cells in early tubal pregnancy.

Material and methods: This study analysed 50 ectopic pregnancy (EP) patients who underwent preoperative magnetic resonance imaging (MRI) DWI in our hospital from January 2021 to December 2023. The apparent diffusion coefficient (ADC) values of the villi were measured, combining with serum β-hCG and progesterone tests. The proliferative activity of chorionic trophoblast cells was determined using Ki67 immunohistochemical staining. The positive cell rate of chorionic villi per field of view was quantified.

Results: By linear regression and correlation analysis, the ADC values of the villi were negatively correlated with β-hCG and progesterone levels (P<.001, .001, r=-0.644, -0.754), and chorionic ADC values were negatively correlated with the rate of Ki67-stained positive cells (P<.001, r=-0.863). The percentage of Ki67-stained positive cells was positively correlated with β-hCG and progesterone levels (P<.001, .001, r=0.851, 0.944). The area under the curve of β-hCG, progesterone, ADC, and the combination of β-hCG and ADC in assessing the proliferative activity of chorionic trophoblast cells were 0.937, 0.930, 0.902, and 0.978, respectively. The corresponding sensitivities were 80%, 80%, 80%, and 85%, and the specificities were 66.7%, 66.7%, 90%, and 96%, respectively.

Conclusion: DWI combined with β-hCG provides accurate evaluation of the proliferative activity of trophoblasts, improving patient selection for conservative management and guiding personalised treatment strategies.