Intravoxel incoherent motion diffusion-weighted imaging in evaluating preoperative staging of esophageal squamous cell carcinoma : Evaluation of preoperative stage of primary tumour and prediction of lymph node metastases from esophageal cancer using IVIM: a prospective study.

IF 3.5 2区 医学 Q2 ONCOLOGY Cancer Imaging Pub Date : 2024-08-29 DOI:10.1186/s40644-024-00765-w
Tao Song, Shuang Lu, Jinrong Qu, Hongkai Zhang, Zhaoqi Wang, Zhengyan Jia, Hailiang Li, Yan Zhao, Jianjun Qin, Wen Feng, Shaoyu Wang, Xu Yan
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Abstract

Background: The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.

Methods: Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm2) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D*, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D*, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.

Results: The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D*: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D* and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*: 46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10- 3 mm2/s vs. (2.55 ± 0.40) ×10- 3 mm2/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10- 3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D* and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.

Conclusions: IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.

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利用体内非相干运动弥散加权成像评估食管鳞状细胞癌的术前分期:利用IVIM评估原发肿瘤的术前分期和预测食管癌的淋巴结转移:一项前瞻性研究。
研究背景本研究的目的是前瞻性地调查体外非相干运动(IVIM)在对原发性食管鳞状细胞癌(ESCC)分期和预测ESCC淋巴结转移方面的诊断性能:从2016年4月至2019年4月,63名ESCC患者被纳入前瞻性研究。手术前在 3.0T MRI 系统上使用 iShim 技术(b = 0、25、50、75、100、200、400、600、800 s/mm2)进行 MR 和 IVIM 检查。原发肿瘤表观弥散系数(ADC)和IVIM参数,包括真弥散系数(D)、假弥散系数(D*)和假弥散分数(f)由两名独立的放射科医生测量。评估了不同 T 期和 N 期 D、D*、f 和 ADC 值的差异。通过计算类内相关系数(ICC)来评估两位读者之间的观察者间一致性。使用接收器操作特征曲线(ROC)分析确定了D、D*、f和ADC值在ESCC原发肿瘤分期和淋巴结转移预测中的诊断性能:IVIM参数和ADC的观察者间共识非常好(D:ICC = 0.922;D*:ICC = 0.892;f:ICC = 0.948;ADC:ICC = 0.958)。T1 + T2 组的 ADC、D、D* 和 f 值明显高于 T3 + T4a 组[ADC:(2.55 ± 0.43)×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*:46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]。淋巴结阳性(N+)组的ADC、D和f值明显低于淋巴结阴性(N0)组[ADC:(2.10±0.33)×10- 3 mm2/s vs. (2.55±0.40)×10- 3 mm2/s,t=-4.3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P * 和 f 在区分 T1 + T2 组和 T3 + T4a 组时产生的曲线下面积(AUC)(0.814)最高。D 联合 f 在鉴别 ESCC 的 N + 组和 N0 组方面具有最高的诊断性能(AUC = 0.849):IVIM可作为一种有效的功能成像技术,用于评估原发肿瘤的术前分期和预测ESCC是否存在淋巴结转移。
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来源期刊
Cancer Imaging
Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.
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