Share this content in WeChat
Clinical Article
Quantitative assessment of microsatellite instability in endometrial cancer by T2 mapping combined with mDixon-Quant multiparameter imaging
MA Changjun  TIAN Shifeng  CHEN Lihua  SONG Qingling  SONG Qingwei  LIN Liangjie  LIU Ailian 

Cite this article as: Ma CJ, Tian SF, Chen LH, et al. Quantitative assessment of microsatellite instability in endometrial cancer by T2 mapping combined with mDixon-Quant multiparameter imaging[J]. Chin J Magn Reson Imaging, 2022, 13(8): 48-54. DOI:10.12015/issn.1674-8034.2022.08.009.

[Abstract] Objective To explore the application value of T2 mapping combined with mDixon-Quant multiparameter imaging in quantitative assessment of microsatellite instability (MSI) in endometrial cancer (EC).Materials and Methods The imaging data of 34 EC patients who were pathologically confirmed in our hospital from June 2019 to September 2021 were retrospectively analyzed. All patients underwent 3.0 T magnetic resonance imaging examination two weeks before surgery, and the scanning sequence included T1WI, T2WI, T2 mapping, mDixon-Quant, etc. Two observers independently and blindly measured the T2 value of the lesion T2 mapping sequence and the fat fraction (FF) value, R2* value and T2* value of the mDixon-Quant sequence. The intra-class correlation coefficient (ICC) was used to evaluate the consistency of the measurement results between the two observers, and the independent samples t-test or Mann-Whitney U test was used to compare the differences of each parameter value. The efficacy of parameters to predict EC MSI status was assessed using receiver operating characteristic (ROC) curves. The Delong test was used to compare the differences among the area under the curves (AUCs).Results The agreement between the two observers' measurements was good (ICC>0.75). The R2* value and T2 value of the MSI group were higher than those of the microsatellite stabilization (MSS) group, and the T2* value of the MSI group was lower than that of the MSS group, and the differences were statistically significant (P<0.05). The AUC values of R2* value, T2* value, T2 value and the combined parameters for evaluating the MSI status of EC were 0.773, 0.761, 0.780 and 0.939, respectively; the results of Delong test showed that there was no significant difference in the AUC of each single parameter for evaluating the MSI status of EC (P>0.05). There is a statistically significant difference between the AUC of the combined parameter to assess the EC MSI status and the AUC of the single parameter to assess the EC MSI status (P<0.05).Conclusions Both mDixon-Quant and T2 mapping multi-parameter imaging can quantitatively evaluate EC MSI status. The combination of the two can significantly improve the prediction performance and has a good clinical application prospect.
[Keywords] endometrial cancer;microsatellite instability;T2 mapping;mDixon-Quant;magnetic resonance imaging

MA Changjun1, 2   TIAN Shifeng1, 2   CHEN Lihua1, 2   SONG Qingling1, 2   SONG Qingwei1, 2   LIN Liangjie3   LIU Ailian1, 2*  

1 Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

2 Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian 116011, China

3 Philips (China) Investment Co, Ltd., Shanghai 200040, China

Liu AL, E-mail:

Conflicts of interest   None.

Received  2022-03-22
Accepted  2022-08-05
DOI: 10.12015/issn.1674-8034.2022.08.009
Cite this article as: Ma CJ, Tian SF, Chen LH, et al. Quantitative assessment of microsatellite instability in endometrial cancer by T2 mapping combined with mDixon-Quant multiparameter imaging[J]. Chin J Magn Reson Imaging, 2022, 13(8): 48-54. DOI:10.12015/issn.1674-8034.2022.08.009.

Zheng RS, Sun KX, Zhang SW, et al. Report of cancer epidemiology in China, 2015[J]. Chin J Oncol, 2019(1): 19-28. DOI: 10.3760/cma.j.issn.0253-3766.2019.01.005.
Chinese Anti-Cancer Association Gynecological Oncology Committee. Guidelines for diagnosis and treatment of endometrial cancer (2021 edition)[J]. China Oncol, 2021, 31(6): 501-512. DOI: 10.19401/j.cnki.1007-3639.2021.06.08.
Baretti M, Le DT. DNA mismatch repair in cancer[J]. Pharmacol Ther, 2018, 189: 45-62. DOI: 10.1016/j.pharmthera.2018.04.004.
De' Angelis GL, Bottarelli L, Azzoni C, et al. Microsatellite instability in colorectal cancer[J]. Acta Biomed, 2018, 89(9-S): 97-101. DOI: 10.23750/abm.v89i9-S.7960.
Ma BB, Wang H. Microsatellite instability and its research progress in endometrial cancer[J]. Oncol Prog, 2019, 17(12): 1385-1388. DOI: 10.11877/j.issn.1672-1535.2019.17.12.06.
Tahara S, Kohara M, Sato K, et al. Strong expression of PD-L1 in invasive front of MELF pattern in endometrioid carcinoma[J/OL]. Pathol Res Pract, 2022 [2022-03-22]. DOI: 10.1016/j.prp.2021.153699.
Rousset-Rouviere S, Rochigneux P, Chrétien AS, et al. Endometrial carcinoma: immune microenvironment and emerging treatments in immuno-oncology[J/OL]. Biomedicines, 2021 [2022-03-22]. DOI: 10.3390/biomedicines9060632.
Yamashita H, Nakayama K, Ishikawa M, et al. Microsatellite instability is a biomarker for immune checkpoint inhibitors in endometrial cancer[J]. Oncotarget, 2018, 9(5): 5652-5664. DOI: 10.18632/oncotarget.23790.
Kim J, Kim S, Lee HS, et al. Prognostic implication of programmed cell death 1 protein and its ligand expressions in endometrial cancer[J]. Gynecol Oncol, 2018, 149(2): 381-387. DOI: 10.1016/j.ygyno.2018.02.013.
Zhang P, Liu MY, Cui Y, et al. Microsatellite instability status differentially associates with intratumoral immune microenvironment in human cancers[J/OL]. Brief Bioinform, 2021 [2022-03-22]. DOI: 10.1093/bib/bbaa180.
Lee V, Murphy A, Le DT, et al. Mismatch repair deficiency and response to immune checkpoint blockade[J]. Oncologist, 2016, 21(10): 1200-1211. DOI: 10.1634/theoncologist.2016-0046.
Wang FD, Zhang HP, Wu CY, et al. Quantitative T2 mapping accelerated by GRAPPATINI for evaluation of muscles in patients with myositis[J/OL]. Br J Radiol, 2019 [2022-03-22]. DOI: 10.1259/bjr.20190109.
Chu C, Feng QQ, Zhang HY, et al. Evaluation of salivary gland fat fraction values in patients with primary Sjögren's syndrome by mDIXON quant imaging: initial findings[J/OL]. Eur J Radiol, 2020 [2022-03-22]. DOI: 10.1016/j.ejrad.2019.108776.
Zhou N, Chu C, Dou X, et al. Early evaluation of radiation-induced parotid damage in patients with nasopharyngeal carcinoma by T2 mapping and mDIXON Quant imaging: initial findings[J/OL]. Radiat Oncol, 2018 [2022-03-22]. DOI: 10.1186/s13014-018-0970-9.
Zhang Y, Wang C, Duanmu YY, et al. Comparison of CT and magnetic resonance mDIXON-Quant sequence in the diagnosis of mild hepatic steatosis[J/OL]. Br J Radiol, 2018 [2022-03-22]. DOI: 10.1259/bjr.20170587.
Guo YH, Chen YJ, Zhang XT, et al. Magnetic susceptibility and fat content in the lumbar spine of postmenopausal women with varying bone mineral density[J]. J Magn Reson Imaging, 2019, 49(4): 1020-1028. DOI: 10.1002/jmri.26279.
Stelloo E, Jansen AML, Osse EM, et al. Practical guidance for mismatch repair-deficiency testing in endometrial cancer[J]. Ann Oncol, 2017, 28(1): 96-102. DOI: 10.1093/annonc/mdw542.
Zhang W, Yin HK, Huang ZX, et al. Development and validation of MRI-based deep learning models for prediction of microsatellite instability in rectal cancer[J]. Cancer Med, 2021, 10(12): 4164-4173. DOI: 10.1002/cam4.3957.
Bhosale P, Ramalingam P, Ma JF, et al. Can reduced field-of-view diffusion sequence help assess microsatellite instability in FIGO stage 1 endometrial cancer?[J]. J Magn Reson Imaging, 2017, 45(4): 1216-1224. DOI: 10.1002/jmri.25427.
Tian SF, Liu AL, Yang WP, et al. Quantitative parameters of diffusion tensor imaging predicting microsatellite instability in endometrial carcinoma[J]. J Pract Radiol, 2021, 37(5): 804-808, 834. DOI: 10.3969/j.issn.1002-1671.2021.05.026.
Tian SF, Liu AL, Chen LH, et al. Prediction of microsatellite instability in endometrial carcinoma by multiple quantitative parameters of magnetic sensitive sequence[J]. Chin J Magn Reson Imaging, 2020, 11(7): 493-496. DOI: 10.12015/issn.1674-8034.2020.07.003.
Juras V, Bohndorf K, Heule R, et al. A comparison of multi-echo spin-echo and triple-echo steady-state T2 mapping for in vivo evaluation of articular cartilage[J]. Eur Radiol, 2016, 26(6): 1905-1912. DOI: 10.1007/s00330-015-3979-6.
Ferrero G, Sconfienza LM, Fiz F, et al. Effect of intra-articular injection of intermediate-weight hyaluronic acid on hip and knee cartilage: in-vivo evaluation using T2 mapping[J]. Eur Radiol, 2018, 28(6): 2345-2355. DOI: 10.1007/s00330-017-5186-0.
Sherlock SP, Zhang Y, Binks M, et al. Quantitative muscle MRI biomarkers in Duchenne muscular dystrophy: cross-sectional correlations with age and functional tests[J]. Biomark Med, 2021, 15(10): 761-773. DOI: 10.2217/bmm-2020-0801.
Chaikriangkrai K, Abbasi MA, Sarnari R, et al. Prognostic value of myocardial extracellular volume fraction and T2-mapping in heart transplant patients[J]. JACC Cardiovasc Imaging, 2020, 13(7): 1521-1530. DOI: 10.1016/j.jcmg.2020.01.014.
Payandeh Z, Khalili S, Somi MH, et al. PD-1/PD-L1-dependent immune response in colorectal cancer[J]. J Cell Physiol, 2020, 235(7/8): 5461-5475. DOI: 10.1002/jcp.29494.
Han X, Sun MY, Wang MY, et al. The enhanced T2 star weighted angiography (ESWAN) value for differentiating borderline from malignant epithelial ovarian tumors[J]. Eur J Radiol, 2019, 118: 187-193. DOI: 10.1016/j.ejrad.2019.07.011.
Craft ML, Edwards M, Jain TP, et al. R2 and R2* MRI assessment of liver iron content in an undifferentiated diagnostic population with hyperferritinaemia, and impact on clinical decision making[J/OL]. Eur J Radiol, 2021 [2022-03-22]. DOI: 10.1016/j.ejrad.2020.109473.
Deng J, Neff LM, Rubert NC, et al. MRI characterization of brown adipose tissue under thermal challenges in normal weight, overweight, and obese young men[J]. J Magn Reson Imaging, 2018, 47(4): 936-947. DOI: 10.1002/jmri.25836.
Tang SL, Xu Y, Liu XF, et al. Quantitative susceptibility mapping shows lower brain iron content in children with autism[J]. Eur Radiol, 2021, 31(4): 2073-2083. DOI: 10.1007/s00330-020-07267-w.
Ma CJ, Liu AL, Tian SF, et al. Preliminary study on the application value of APTw combined with mDixon-quant sequence in differentiating early endometrial carcinoma from endometrial polyp[J]. J Clin Radiol, 2022, 41(2): 372-376. DOI: 10.13437/j.cnki.jcr.2022.02.007.
Tian SF, Liu AL, Ren X, et al. Evaluation of Her-2 gene expression in endometrial carcinoma by amide proton transfer weighted and fat quantitative[J]. Chin J Magn Reson Imaging, 2021, 12(11): 70-73.
Otto W, MacRae F, Sierdziński J, et al. Microsatellite instability and manifestations of angiogenesis in stage Ⅳ of sporadic colorectal carcinoma[J/OL]. Medicine (Baltimore), 2019 [2022-03-22]. DOI: 10.1097/MD.0000000000013956.
Maurer GD, Tichy J, Harter PN, et al. Matching quantitative MRI parameters with histological features of treatment-Naïve IDH wild-type glioma[J/OL]. Cancers, 2021 [2022-03-22]. DOI: 10.3390/cancers13164060.
Chuang TC, Chen YL, Shui WP, et al. Intra-tumoral susceptibility signal: a post-processing technique for objective grading of astrocytoma with susceptibility-weighted imaging[J]. Quant Imaging Med Surg, 2022, 12(1): 558-567. DOI: 10.21037/qims-21-58.

PREV Prediction and risk assessment of benign and malignant prostate lesions based on Bp-MRI radiomics
NEXT The value of quantitative assessment of lumbar disc degeneration with T2 mapping: A Meta analysis

Tel & Fax: +8610-67113815    E-mail: