Evaluation and validation of the diagnostic value of the apparent diffusion coefficient for differentiating early-stage endometrial carcinomas from benign mimickers at 3T MRI.
Evaluation and validation of the diagnostic value of the apparent diffusion coefficient for differentiating early-stage endometrial carcinomas from benign mimickers at 3T MRI.
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3T MRI表观扩散系数对区分早期子宫内膜癌与良性模仿者的诊断价值的评估和验证
DOI：
10.18632/oncotarget.18553
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发表时间：
2017-07-11
期刊：
影响因子：
--
通讯作者：
Yan Z
中科院分区：
文献类型：
--
作者：
Wang X;Zhao Y;Hu Y;Zhou Y;Ye X;Liu K;Bai G;Guo A;Du M;Jiang L;Wang J;Yan Z
以往研究者采用1.5T磁共振成像（MRI）获得不同的表观扩散系数（ADC）临界值来区分子宫内膜癌和良性模拟者。很少有研究使用3 T MRI或前瞻性验证这些截止ADC值的有效性。本研究分两个阶段设计，以获得3 T MRI的临界ADC值，并前瞻性验证ADC值的作用。首先，我们对60例患者进行了回顾性研究，以评估ADC的诊断价值，通过获得一个理论的临界值ADC值，以区分良性和恶性子宫内膜病变。t检验显示，I期子宫内膜癌的ADC值显著低于良性病变。受试者工作特性曲线的曲线下面积为0.993，截止ADC值为0.98 × 10−3 mm 2/s。诊断I期子宫内膜癌的敏感性、特异性和总体准确性分别为100%、97.1%和98.3%。其次，我们对26例患者进行了前瞻性研究，以验证研究第一阶段获得的截止ADC值的使用。根据早期获得的ADC值临界值区分恶性和良性子宫内膜病变的敏感性、特异性和总体准确性如下：放射科医师1分别达到86.67%、100.0%和92.31%;放射科医师2分别达到86.67%、91.0%和88.5%。我们的研究结果表明，ADC值可能是一个潜在的生物标志物，作为一个定量和定性的工具，用于区分早期子宫内膜癌和良性mimickers。
Previous researchers obtained various apparent diffusion coefficient (ADC) cutoff values to differentiate endometrial carcinoma from benign mimickers with 1.5T magnetic resonance imaging (MRI). Few studies have used 3T MRI or validated the effectiveness of these cutoff ADC values prospectively. This study was designed in two stages to obtain a cutoff ADC value at 3T MRI and to validate prospectively the role of the ADC value. First, we conducted a retrospective study of 60 patients to evaluate the diagnostic value of ADC by obtain a theoretical cutoff ADC value for differentiating between benign and malignant endometrial lesions. Student's t test revealed that ADC values for stage I endometrial carcinomas were significantly lower than those for benign lesions. The area under the curve value of the receiver operating characteristic curve was 0.993, and the cutoff ADC value was 0.98 × 10−3 mm2/s. The sensitivity, specificity, and overall accuracy of diagnosing stage I endometrial carcinoma were 100%, 97.1%, and 98.3%, respectively. Second, we conducted a prospective study of 26 patients to validate the use of the cutoff ADC value obtained in the study's first stage. The sensitivity, specificity, and overall accuracy for differentiating malignant from benign endometrial lesions based on the cutoff ADC value obtained earlier were as follows: radiologist 1 attained 86.67%, 100.0%, and 92.31%, respectively; radiologist 2 attained 86.67%, 91.0%, and 88.5%, respectively. Our results suggest that ADC values could be a potential biomarker for use as a quantitative and qualitative tool for differentiating between early-stage endometrial carcinomas and benign mimickers.
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