APTw combined with mDixon-Quant imaging to distinguish the differentiation degree of cervical squamous carcinoma

Xing Meng; Shifeng Tian; Changjun Ma; Liangjie Lin; Xiaoxiao Zhang; Jiazheng Wang; Qingwei Song; Ai Lian Liu

doi:10.3389/fonc.2023.1105867

APTw combined with mDixon-Quant imaging to distinguish the differentiation degree of cervical squamous carcinoma

Front Oncol. 2023 Jan 25:13:1105867. doi: 10.3389/fonc.2023.1105867. eCollection 2023.

Authors

Xing Meng^{1

2}, Shifeng Tian¹, Changjun Ma¹, Liangjie Lin³, Xiaoxiao Zhang³, Jiazheng Wang³, Qingwei Song¹, Ai Lian Liu¹

Affiliations

¹ First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
² Radiology Department, Dalian Women and Children's Medical Group, Dalian, Liaoning, China.
³ Radiology Department, Philips (China), Beijing, China.

Abstract

Background: To investigate the value of amide proton transfer weighted (APTw) imaging combined with modified Dixon fat quantification (mDixon-Quant) imaging in determining the degree of differentiation of cervical squamous carcinoma (CSC) against histopathologic.

Methods: Magnetic resonance imaging (MRI) data were collected from 52 CSC patients. According to histopathologic results, patients were divided into the poorly differentiated group (37 cases) and the well/moderately differentiated group (15 cases). The APTw value by APTw imaging and the fat fraction (FF) and transverse relaxation rate $R 2 *$ values by mDixon-Quant were independently measured by two radiologists. Intra-class correlation coefficients (ICCs) were used to test the consistency of APTw, FF, and $R 2 *$ values measured by the two observers. The Mann-Whitney U test was used to analyze the difference in each parameter between the two groups. Logistic regression analysis was used to assess the association between the degree of differentiation on histopathology and imaging parameters by APTw and mDixon Quant. The ROC curve was used to evaluate the diagnostic efficacy of various parameters and their combination in distinguishing the degree of CSC differentiation on histopathology. The DeLong test was used to access the differences among the area under the ROC curves (AUCs). The Pearson correlation coefficient was used to evaluate the correlation between APTw and mDixon-Quant imaging parameters.

Results: The APTw means were 2.95 ± 0.78% and 2.05 (1.85, 2.65)% in the poorly and well/moderately differentiated groups, respectively. The $R 2 *$ values were 26.62 (21.99, 33.31)/s and 22.93 ± 6.09/s in the poorly and well/moderately differentiated groups, respectively (P < 0.05). The AUCs of APTw, $R 2 *$ , and their combination were 0.762, 0.686, and 0.843, respectively. The Delong test suggested statistical significance between $R 2 *$ and the combination of APTw and $R 2 *$ . $R 2 *$ values showed a significant correlation with APTw values in the poorly differentiated group.

Conclusions: APTw combined with mDixon-Quant can be used to efficiently distinguish the differention degrees of CSC diagnosed on histopathology.

Keywords: amide proton transfer weighted; cervical squamous carcinoma; magnetic resonance imaging; modified Dixon-Quant; transverse relaxation rate.