DKI and 1H-MRS in angiogenesis evaluation of soft tissue sarcomas: a prospective clinical study based on MRI-pathology control method.

Abstract

Background: The vascular endothelial growth factor (VEGF) and microvessel density (MVD) have been widely employed as angiogenesis indicators in the diagnosis and treatment of soft tissue sarcomas. While diffusion kurtosis imaging (DKI) and proton magnetic resonance spectroscopy (¹H-MRS) imaging hold potential in assessing angiogenesis in other tumors, their reliability in correlating with angiogenesis in soft tissue sarcomas remains uncertain, contingent upon accurately acquiring the region of interest (ROI).

Methods: 23 patients with soft tissue sarcomas (STSs) confirmed by pathology were selected, underwent DKI and ¹H-MRS at 3.0T MRI. The DKI parameters mean diffusivity (MD), mean kurtosis (MK), kurtosis anisotropy (KA), and ¹H-MRS parameters choline (Cho), lipid/lactate (LL) were measured by two radiologists. Two pathologists obtained pathological slices using a new sampling method called MRI-pathology control and evaluated VEGF and MVD in the selected regions. Correlations between MRI parameters and angiogenesis markers were assessed by Person or Spearman tests.

Results: The DKI parameters MD and KA, and the ¹H-MRS parameters Cho and LL, have varying degrees of correlation with the expression levels of VEGF and MVD. Among them, Cho exhibits the strongest correlation (r = 0.875, P < 0.001; r = 0.807, P < 0.001).

Conclusion: Based on this preliminary clinical studies, DKI and ¹H-MRS parameters are correlated with angiogenesis markers obtained through the "MRI-pathology control" method.