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

Abstract

Background Amide proton transfer‐weighted (APTw) imaging has shown great potential in the diagnosis of cancer, but has yet not been well studied in cervical cancer. Purpose To evaluate the image quality and clinical feasibility of APTw MRI for cervical cancer. Study Type Prospective. Population In all, 75 patients with cervical lesions and 49 healthy volunteers. Field Strength/Sequence 3.0 T, 3D turbo spin echo (TSE) APTw sequence. Assessment Three radiologists, blinded to the clinical data, independently evaluated APTw image quality with a 5‐point Likert scale on 64 patients with pathologically confirmed cervical cancer. APT values, calculated based on asymmetry of acquired Z‐spectrum with respect to water frequency, using 3D turbo spin echo volume acquisition with B0 correction, were independently measured by two radiologists, twice for each observer, on 52 cervical cancer lesions and 49 normal cervical stroma with a mean region of interest area of 638.6 mm2 and 557.5 mm2, respectively. Statistical Tests Interobserver agreement was evaluated by Kendall's W test. Intra‐ and interobserver interclass correlation coefficients (ICC) were computed. Student's t‐test was used to compare the differences of APT values between cervical cancer and normal cervix; receiver operating characteristic analysis was performed. Results Most cases revealed good APTw image quality with excellent agreement (Kendall's W = 0.850, P < 0.001). APT values of cervical cancer and normal cervical stroma were 2.745 ± 0.065 and 1.853 ± 0.059, respectively, with a significant difference (P < 0.0001). Intraobserver ICCs were 0.963 and 0.960 for two readers. Interobserver ICC was 0.993. Area under the curve (AUC) for differentiating cervical cancer from normal cervical stroma was 0.927. The feasible threshold value for AUC was determined as 2.221 with sensitivity of 84.62% and specificity of 83.66%. Data Conclusion 3D TSE APTw MRI is feasible in cervical cancer. Cervical cancer showed significantly higher APT values than normal cervix. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1318–1325.

Novel T2 Mapping for Evaluating Cervical Cancer Features by Providing Quantitative T2 Maps and Synthetic Morphologic Images: A Preliminary Study

“…5 To date, multiple novel magnetic resonance imaging (MRI) techniques, such as diffusion-weighted imaging (DWI) based on monoexponential and nonmonoexponential models, dynamic contrast-enhanced (DCE) quantitative analysis, blood oxygenation level-dependent (BOLD), and amide proton transfer-weighted (APTw) MRI have been applied to analyze the pathological features of CC. [6][7][8][9] However, except for DWI based on the monoexponential model, all these techniques face issues of excessive scanning duration, complicated image postprocessing, or low reproducibility. These factors restrict their wide application in clinical practice.…”

Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value

“…The main challenge for APT imaging is B0 field inhomogeneity (20). Ideally, the APT calculation only needs to acquire images with saturation RF applied at ±3.5 ppm.…”

“…Investigators in recent human studies have also reported preliminary APT findings in the breast (16)(17)(18)(19), cervices (20,21), prostate (22,23), and chest (8), demonstrating that it is an effective tool for tumor detection and characterization. APT values were higher in cancers than in normal surrounding tissues (22) and benign tumors (8).…”

A review of the research progress of medical imaging

“…; 利用表观弥散系数(apparent diffusion coefficient, ADC)定量特征, 实现术前对宫颈癌转移淋巴结 的精准检出和分期评估, 成功预测宫颈癌病理类型及 分化程度, 辅助临床治疗方案制定 [46] . 在国际上率先 开展了全球最大样本量的女性生殖系统酰胺质子转移 加权(amide proton transfer weighted, APTw)成像研究, 探索了国际新兴APTw成像技术在宫颈癌、子宫内膜 癌、子宫腺肌症中的应用价值 [47] .…”