Diffusion Kurtosis Imaging for Differentiating Borderline From Malignant Epithelial Ovarian Tumors: A Correlation With Ki-67 Expression
Diffusion Kurtosis Imaging for Differentiating Borderline From Malignant Epithelial Ovarian Tumors: A Correlation With Ki-67 Expression
复制标题
弥散峭度成像用于区分交界性卵巢肿瘤和恶性上皮性卵巢肿瘤：与 Ki-67 表达的相关性
DOI：
10.1002/jmri.25696
复制
发表时间：
2017-11-01
影响因子：
4.4
通讯作者：
Gu, Wei Yong
中科院分区：
文献类型：
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作者：
Li, Hai Ming;Zhao, Shu Hui;Gu, Wei Yong
目的：探讨弥散峰度成像(DKI)在卵巢交界性肿瘤与恶性上皮性肿瘤(MEOT)鉴别诊断中的应用及其与Ki-67表达的相关性。材料和方法：对52例卵巢上皮性肿瘤患者(卵巢交界性肿瘤17例，卵巢交界性上皮性肿瘤35例)进行前瞻性评价，采用1.5T磁共振成像机，采用DKI，b值分别为0,500,1000,1500,2000和2500 S/mm2，标准弥散加权成像(DWI)，b值分别为0和1000 S/mm2。测量两组间的峰度(K)、弥散系数(D)和标准弥散系数(ADC)，并与Ki-67表达进行相关性分析。使用Mann-Whitney U检验、受试者工作特征(ROC)曲线和Spearman相关性进行统计分析。结果：BEOTS的K值显著低于MEOTS(0.5560.09比0.960.2)，而D和ADC值显著高于MEOTS(2.2760.35比1.3960.37和1.7260.36比1.160.25)(P<；0.001)。鉴别BEOT和MEOTS的敏感性、特异性和准确性分别为K值88.2%、94.3%和92.3%，D值88.2%、91.4%和90.4%，ADC值88.2%、88.6%和88.5%。但上述三个参数在诊断性能上无差异(Kvs.ADC，P50.203；Dvs.ADC，P50.148；Kvs.D，P50.904)。K值与Ki-67表达呈正相关(r50.699)，D、ADC值与Ki-67表达呈负相关(r5-0.680，-0.665)。结论：初步发现DKI是鉴别BEOT和MEOT的一种替代工具，并与Ki-67的表达有关。然而，与标准的DWI相比，DKI没有发现任何附加值。证据级别：1技术效力：阶段2
Purpose: To investigate the use of diffusion kurtosis imaging (DKI) in differentiating borderline from malignant epithelial ovarian tumors (MEOTs) and to correlate DKI parameters with Ki-67 expression. Materials and Methods: Fifty-two consecutive patients with epithelial ovarian tumors (17 borderline epithelial ovarian tumors, BEOTs; 35 MEOTs) were prospectively evaluated using DKI with b values of 0, 500, 1000, 1500, 2000, and 2500 s/ mm 2 and standard diffusion-weighted imaging (DWI) with b values of 0 and 1000 s/ mm 2 using a 1.5T magnetic resonance imaging (MRI) unit. The kurtosis (K) and diffusion coefficient (D) from DKI and apparent diffusion coefficient (ADC) from standard DWI were measured, compared, and correlated with Ki-67 expression between the two groups. Statistical analyses were performed using theMann-Whitney U-test, receiver operating characteristic (ROC) curves, and Spearman's correlation. Results: The K value was significantly lower in BEOTs than in MEOTs (0.5560.09 vs. 0.960.2), while the D and ADC values were significantly higher in BEOTs than in MEOTs (2.2760.35 vs. 1.3960.37 and 1.7260.36 vs. 1.160.25, respectively) (P < 0.001). For differentiating between BEOTs and MEOTs, the sensitivity, specificity, and accuracy were 88.2%, 94.3%, and 92.3% for K value; 88.2%, 91.4%, and 90.4% for D value; and 88.2%, 88.6%, and 88.5% for ADC value, respectively. However, there were no differences in the diagnostic performances among the three parameters above (K vs. ADC, P50.203; D vs. ADC, P50.148; K vs. D, P50.904). The K value was positively correlated with Ki-67 expression (r50.699), while the D and ADC values were negatively correlated with Ki-67 expression (r5-0.680, -0.665, respectively). Conclusion: Preliminary findings demonstrate that DKI is an alternative tool for differentiating BEOTs from MEOTs, and is correlated with Ki-67 expression. However, no added value is found for DKI compared with standard DWI. Level of Evidence: 1 Technical Efficacy: Stage 2