Amide Proton Transfer MR Imaging of Endometrioid Endometrial Adenocarcinoma: Association with Histologic Grade

Abstract

Purpose To evaluate the utility of amide proton transfer (APT) imaging in estimating histologic grades of endometrioid endometrial adenocarcinoma (EEA). Materials and Methods The institutional review board approved this prospective study. Between June 2012 and March 2016, 32 patients with EEA underwent magnetic resonance (MR) imaging. After their surgical procedures, their EEAs were confirmed pathologically and classified into histologic grades: grade 1 (n = 11), grade 2 (n = 11), and grade 3 (n = 10). The APT signal intensities (SIs) and the mean and minimum apparent diffusion coefficients (ADCs) of the three grades were calculated and compared. Spearman rank correlation coefficient was also calculated between the APT SIs and histologic grades, and between the ADCs and histologic grades. Results The Spearman correlation coefficient with histologic grade of the APT SIs, the mean ADC, and the minimum ADC were 0.55 (P = .001), 0.03 (P = .84), and -0.30 (P = .09), respectively. The average APT SIs and the mean and minimum ADCs were 2.2% ± 0.2 (standard deviation), 0.9 × 10 mm/sec ± 0.2, and 0.6 × 10 mm/sec ± 0.1 for grade 1; 3.2% ± 0.3, 0.8 × 10 mm/sec ± 0.1, and 0.5 × 10 mm/sec ± 0.1 for grade 2; and 3.7% ± 0.3, 0.9 × 10 mm/sec ± 0.1, and 0.5 × 10 mm/sec ± 0.1 for grade 3, respectively. The APT SIs of grade 3 EEA were significantly higher than those of grade 1 EEA (P = .01), but other pairwise comparisons did not reveal any significant differences (P = .06-.51). The mean and minimum ADCs showed no significant differences among the three histologic grades (P =.13-.51). Conclusion The APT SI was positively correlated with the histologic grades of EEA. RSNA, 2017 Online supplemental material is available for this article.

Amide proton transfer imaging to evaluate the grading of squamous cell carcinoma of the cervix: A comparative study using 18F FDG PET

“…Other studies have also demonstrated the role of APT for distinguishing necrosis and pseudoprogression from true progression or recurrence in gliomas. Recently, the application of APT to endometrial cancer was reported by Takayama et al Their analyses revealed that aggressive endometrial adenocarcinoma had a high APT SI, but a less aggressive endometrial adenocarcinoma showed a low APT SI.…”

“…APT imaging is available on 3 T MR scanners and has shown great potential value in the clinic . The application of APT to the grading of brain tumors, lung cancer, prostate tumors, and endometrial cancer has been reported . We hypothesized that APT imaging could be useful for grading SCCC.…”

“…20 The application of APT to the grading of brain tumors, [21][22][23] lung cancer, prostate tumors, and endometrial cancer has been reported. [24][25][26] We hypothesized that APT imaging could be useful for grading SCCC.…”

Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study

“…The clinical utility of APTw imaging for estimating the tumor of glioma, head and neck, breast, lung cancers, prostate cancers, and rectal cancer has been reported . In 2018, Takayama et al reported the first use of 2D APTw imaging on the uterus; the APT signal intensity was positively correlated with the histologic grades of endometrioid endometrial adenocarcinoma . Recently, a published APTw study on 31 cervical squamous cell carcinoma patients showed that APT signal intensity was positively correlated with histological grades .…”

“…[9][10][11][12][13][14] In 2018, Takayama et al reported the first use of 2D APTw imaging on the uterus; the APT signal intensity was positively correlated with the histologic grades of endometrioid endometrial adenocarcinoma. 15 Recently, a published APTw study on 31 cervical squamous cell carcinoma patients showed that APT signal intensity was positively correlated with histological grades. 16 In this promising study, 18 (36.73%) patients were excluded because of severe artifacts or insignificant lesions.…”