Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings

Cancer Imaging

Richard L Ehman¹  Sudhakar K Venkatesh¹  Phillip Rossman¹  Kevin J Glaser¹  Xi Long²  Tianhui Zhang²  Mayidili Nijiati³  Jie Zhu⁴  Jin Wang⁴  Linqi Zhang⁴  Mengsi Li⁴  Sichi Kuang⁴  Bingjun He⁴  Ying Deng⁴  Yuanqiang Xiao⁴  Jingbiao Chen⁴ 

[1] Department of Radiology, Mayo Clinic, Rochester, MN, United States;Department of Radiology, Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital of Sun Yat-sen University, Meizhou, People’s Republic of China;Department of Radiology, The First People’s Hospital of Kashi Area, Kashi, People’s Republic of China;Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China;

关键词: Magnetic resonance elastography (MRE);    Tumor stiffness;    Endometrial carcinoma (EC);    Tumor aggressiveness;   

DOI  :  10.1186/s40644-021-00420-8

来源: Springer

【 摘 要 】

BackgroundPreoperative evaluation of aggressiveness, including tumor histological subtype, grade of differentiation, Federation International of Gynecology and Obstetrics (FIGO) stage, and depth of myometrial invasion, is significant for treatment planning and prognosis in endometrial carcinoma (EC). The purpose of this study was to evaluate whether three-dimensional (3D) magnetic resonance elastography (MRE) can help predict the aggressiveness of EC.MethodsFrom August 2015 to January 2019, 82 consecutive patients with suspected uterine tumors underwent pelvic MRI and MRE scans, and 15 patients with confirmed EC after surgical resection were enrolled. According to pathological results (tumor grade, histological subtype, FIGO stage, and myometrial invasiveness), the patients were divided into two subgroups. The independent-samples t-test or Mann-Whitney U test was used to compare the stiffness between different groups. The diagnostic performance was determined with receiver operating characteristic (ROC) curve analysis.ResultsThe stiffness of EC with ≥ 50 % (n = 6) myometrial invasion was significantly higher than that with < 50 % (n = 9) myometrial invasion (3.68 ± 0.59 kPa vs. 2.61 ± 0.72 kPa, p = 0.009). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 77.8 % specificity for differentiating ≥ 50 % myometrial invasion from < 50 % myometrial invasion of EC. The stiffness of poorly differentiated EC (n = 8) was significantly higher than that of well/moderately differentiated EC (n = 7) (3.47 ± 0.64 kPa vs. 2.55 ± 0.82 kPa, p = 0.028). Using a stiffness of 3.04 kPa as a cutoff value resulted in 75 % sensitivity and 71.4 % specificity for differentiating poorly differentiated from well/moderately differentiated EC. The stiffness of FIGO stage II/III EC was significantly higher than that of FIGO stage I EC (3.69 ± 0.65 kPa vs. 2.72 ± 0.76 kPa, p = 0.030). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 70 % specificity for differentiating FIGO stage I EC from FIGO stage II/III EC. The tumor stiffness value in type II (n = 3) EC was higher than that in type I (n = 12) EC (3.67 ± 0.59 kPa vs. 2.88 ± 0.85 kPa), but the difference was not significant (p = 0.136).ConclusionsTumor stiffness measured by 3D MRE may be potentially useful for predicting tumor grade, FIGO stage and myometrial invasion of EC and can aid in the preoperative risk stratification of EC.

【 授权许可】

CC BY