Wenyi Yue, Ruxue Han, Junzhong Xu, Chaoyang Jin, Xiaoyu Jiang, Dandan Zheng, Jing Peng, Jun Lu, Qiming Liu, Ning Xu, Dan Zhao, Hua Li, Qi Yang
{"title":"定量时间依赖扩散MRI对子宫内膜癌的诊断和侵袭性评估:一项前瞻性研究。","authors":"Wenyi Yue, Ruxue Han, Junzhong Xu, Chaoyang Jin, Xiaoyu Jiang, Dandan Zheng, Jing Peng, Jun Lu, Qiming Liu, Ning Xu, Dan Zhao, Hua Li, Qi Yang","doi":"10.3348/kjr.2025.0633","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Preoperative differentiation of benign and malignant endometrial lesions, along with the identification of aggressive histological types of endometrial cancer (EC), is crucial for guiding treatment strategies. Time-dependent diffusion magnetic resonance imaging (TDD-MRI), which allows the characterization of tissue microstructure at the cellular level, is not currently applied for endometrial lesions. This study aimed to evaluate TDD-MRI-derived microstructural parameters for noninvasively distinguishing benign and malignant endometrial lesions and predicting aggressive histological types of EC.</p><p><strong>Materials and methods: </strong>This prospective study enrolled 177 patients with clinically suspected EC who underwent TDD-MRI between January 2024 and March 2025. The Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion method was used to extract microstructural parameters, including the cell diameter (d), intracellular volume fraction (<i>v</i><sub>in</sub>), cellularity (number of cells per unit area), cellularity index (<i>v</i><sub>in</sub>/d), and extracellular diffusivity (<i>D</i><sub>ex</sub>), along with three apparent diffusion coefficient measurements. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance. The Pearson correlation coefficient between the microstructural parameters and histopathological measurements was calculated.</p><p><strong>Results: </strong>A total of 130 women (mean ± standard deviation age: 56 ± 14 years) administered uterine curettage or surgery were included in the final analysis. All microstructural parameters showed significant differences between benign endometrial lesions and EC (<i>P</i> < 0.05), as well as between nonaggressive and aggressive EC (<i>P</i> < 0.05). Cellularity exhibited the highest AUC of 0.86 for distinguishing benign endometrial lesions from EC, whereas the cellularity index showed the highest AUC of 0.88 for distinguishing aggressive histological types. D<sub>0Hz</sub> was positively correlated with <i>D</i><sub>ex</sub> (<i>P</i> < 0.05) and negatively correlated with diameter (<i>P</i> < 0.05), cellularity index (<i>P</i> < 0.01) and <i>v</i><sub>in</sub> (<i>P</i> < 0.001) in patients with benign endometrial lesions. D<sub>0Hz</sub> was positively correlated with <i>D</i><sub>ex</sub> (<i>P</i> < 0.001) and negatively correlated with <i>v</i><sub>in</sub> (<i>P</i> < 0.001) in patients with EC. Microstructural parameters strongly correlated with corresponding pathological features (<i>r</i> = 0.77-0.83; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TDD-MRI-derived microstructural parameters demonstrated high performance in differentiating benign from malignant endometrial diseases and identifying aggressive types of EC.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 10","pages":"973-985"},"PeriodicalIF":5.3000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479230/pdf/","citationCount":"0","resultStr":"{\"title\":\"Quantitative Time-Dependent Diffusion MRI for Diagnosis and Aggressiveness Assessment of Endometrial Cancer: A Prospective Study.\",\"authors\":\"Wenyi Yue, Ruxue Han, Junzhong Xu, Chaoyang Jin, Xiaoyu Jiang, Dandan Zheng, Jing Peng, Jun Lu, Qiming Liu, Ning Xu, Dan Zhao, Hua Li, Qi Yang\",\"doi\":\"10.3348/kjr.2025.0633\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Preoperative differentiation of benign and malignant endometrial lesions, along with the identification of aggressive histological types of endometrial cancer (EC), is crucial for guiding treatment strategies. Time-dependent diffusion magnetic resonance imaging (TDD-MRI), which allows the characterization of tissue microstructure at the cellular level, is not currently applied for endometrial lesions. This study aimed to evaluate TDD-MRI-derived microstructural parameters for noninvasively distinguishing benign and malignant endometrial lesions and predicting aggressive histological types of EC.</p><p><strong>Materials and methods: </strong>This prospective study enrolled 177 patients with clinically suspected EC who underwent TDD-MRI between January 2024 and March 2025. The Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion method was used to extract microstructural parameters, including the cell diameter (d), intracellular volume fraction (<i>v</i><sub>in</sub>), cellularity (number of cells per unit area), cellularity index (<i>v</i><sub>in</sub>/d), and extracellular diffusivity (<i>D</i><sub>ex</sub>), along with three apparent diffusion coefficient measurements. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance. The Pearson correlation coefficient between the microstructural parameters and histopathological measurements was calculated.</p><p><strong>Results: </strong>A total of 130 women (mean ± standard deviation age: 56 ± 14 years) administered uterine curettage or surgery were included in the final analysis. All microstructural parameters showed significant differences between benign endometrial lesions and EC (<i>P</i> < 0.05), as well as between nonaggressive and aggressive EC (<i>P</i> < 0.05). Cellularity exhibited the highest AUC of 0.86 for distinguishing benign endometrial lesions from EC, whereas the cellularity index showed the highest AUC of 0.88 for distinguishing aggressive histological types. D<sub>0Hz</sub> was positively correlated with <i>D</i><sub>ex</sub> (<i>P</i> < 0.05) and negatively correlated with diameter (<i>P</i> < 0.05), cellularity index (<i>P</i> < 0.01) and <i>v</i><sub>in</sub> (<i>P</i> < 0.001) in patients with benign endometrial lesions. D<sub>0Hz</sub> was positively correlated with <i>D</i><sub>ex</sub> (<i>P</i> < 0.001) and negatively correlated with <i>v</i><sub>in</sub> (<i>P</i> < 0.001) in patients with EC. Microstructural parameters strongly correlated with corresponding pathological features (<i>r</i> = 0.77-0.83; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TDD-MRI-derived microstructural parameters demonstrated high performance in differentiating benign from malignant endometrial diseases and identifying aggressive types of EC.</p>\",\"PeriodicalId\":17881,\"journal\":{\"name\":\"Korean Journal of Radiology\",\"volume\":\"26 10\",\"pages\":\"973-985\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479230/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Korean Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3348/kjr.2025.0633\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3348/kjr.2025.0633","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Quantitative Time-Dependent Diffusion MRI for Diagnosis and Aggressiveness Assessment of Endometrial Cancer: A Prospective Study.
Objective: Preoperative differentiation of benign and malignant endometrial lesions, along with the identification of aggressive histological types of endometrial cancer (EC), is crucial for guiding treatment strategies. Time-dependent diffusion magnetic resonance imaging (TDD-MRI), which allows the characterization of tissue microstructure at the cellular level, is not currently applied for endometrial lesions. This study aimed to evaluate TDD-MRI-derived microstructural parameters for noninvasively distinguishing benign and malignant endometrial lesions and predicting aggressive histological types of EC.
Materials and methods: This prospective study enrolled 177 patients with clinically suspected EC who underwent TDD-MRI between January 2024 and March 2025. The Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion method was used to extract microstructural parameters, including the cell diameter (d), intracellular volume fraction (vin), cellularity (number of cells per unit area), cellularity index (vin/d), and extracellular diffusivity (Dex), along with three apparent diffusion coefficient measurements. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance. The Pearson correlation coefficient between the microstructural parameters and histopathological measurements was calculated.
Results: A total of 130 women (mean ± standard deviation age: 56 ± 14 years) administered uterine curettage or surgery were included in the final analysis. All microstructural parameters showed significant differences between benign endometrial lesions and EC (P < 0.05), as well as between nonaggressive and aggressive EC (P < 0.05). Cellularity exhibited the highest AUC of 0.86 for distinguishing benign endometrial lesions from EC, whereas the cellularity index showed the highest AUC of 0.88 for distinguishing aggressive histological types. D0Hz was positively correlated with Dex (P < 0.05) and negatively correlated with diameter (P < 0.05), cellularity index (P < 0.01) and vin (P < 0.001) in patients with benign endometrial lesions. D0Hz was positively correlated with Dex (P < 0.001) and negatively correlated with vin (P < 0.001) in patients with EC. Microstructural parameters strongly correlated with corresponding pathological features (r = 0.77-0.83; P < 0.001).
Conclusion: TDD-MRI-derived microstructural parameters demonstrated high performance in differentiating benign from malignant endometrial diseases and identifying aggressive types of EC.
期刊介绍:
The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences.
A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge.
World''s outstanding radiologists from many countries are serving as editorial board of our journal.