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Clinical Article
Value of amide proton transfer imaging and intravoxel incoherent motion imaging in estimating histologic grades of endometrial adenocarcinoma
KONG Yaqing  QU Qianqian  MING Lei  WANG Zhe  DENG Kai 

Cite this article as: Kong YQ, Qu QQ, Ming L, et al. Value of amide proton transfer imaging and intravoxel incoherent motion imaging in estimating histologic grades of endometrial adenocarcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 46-52. DOI:10.12015/issn.1674-8034.2022.09.009.

[Abstract] Objective To investigate the effect of amide proton transfer (APT) imaging and intravoxel incoherent motion (IVIM) imaging in estimating histologic grades of endometrial adenocarcinoma (EA).Materials and Methods A total of 39 patients with pathologically confirmation of EA underwent pelvic magnetic resonance imaging (grade Ⅰ, n=16; grade Ⅱ, n=14; grade Ⅲ, n=9), including APT and IVIM sequences. APT values and IVIM-derived parameters (f, D, D*) of lesions were calculated respectively by two radiologists. We used a Shapiro-Wilk test to evaluate whether the APT values and IVIM-derived parameters were normally distributed. The intraclass correlation coefficient (ICC) was calculated to describe the correlations of the measurements of each parameter between two readers. The differences of APT values and IVIM-derived parameters were calculated and compared among three grades. Then the receiver operating characteristic (ROC) curves and DeLong test were used to evaluate the efficiency of the parameters with statistically differences. Spearman's correlation analysis was also used between APT values and histologic grades, between IVIM-derived parameters and histologic grades, and between APT values and IVIM-derived parameters.Results All parameters in our research were normally distributed. The ICC of APT values and IVIM-derived parameters between the two readers showed excellent interobserver agreements (APT: 0.955; f: 0.958; D: 0.964; D*: 0.825). The APT values for grade Ⅱ and grade Ⅲ (3.17%±0.43%, 3.45%±0.42%) were significantly higher than grade Ⅰ (2.66%±0.63%), with statistically significant differences (P=0.012, P=0.001). The f values for grade Ⅱ and grade Ⅲ (0.170%±0.049%, 0.150%±0.011%) were significantly lower than grade Ⅰ (0.220%±0.080%), with statistically significant differences (P=0.027, P=0.010). The ROC analysis showed the AUC (area under the curve) of the APT values, f values and the combined diagnosis of both were as follows: grade Ⅰ vs. grade Ⅱ: 0.78, 0.70, 0.83; grade Ⅰ vs. grade Ⅲ: 0.86, 0.81, 0.92. There were no significant differences in AUC comparison among APT values, f values and combined diagnosis of both. APT values showed a positive correlation with histologic grades (rs=0.578, P<0.001) while f values showed a negative correlation (rs=-0.416, P=0.008).Conclusions APT values and f values were correlated with the histologic grades of EA, and there was no significant difference of APT values and f values in differentiating the histologic grades of EA. APT and IVIM imaging may be helpful to predict histologic grades of EA.
[Keywords] amide proton transfer imaging;intravoxel incoherent motion imaging;endometrial adenocarcinoma;histologic grades;functional magnetic resonance imaging

KONG Yaqing1, 2   QU Qianqian1   MING Lei1   WANG Zhe1   DENG Kai1*  

1 Department of Radiology, the First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qian Foshan Hospital), Jinan 250014, China

2 Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan 271016, China

*Deng K, E-mail:

Conflicts of interest   None.

Received  2022-05-19
Accepted  2022-08-30
DOI: 10.12015/issn.1674-8034.2022.09.009
Cite this article as: Kong YQ, Qu QQ, Ming L, et al. Value of amide proton transfer imaging and intravoxel incoherent motion imaging in estimating histologic grades of endometrial adenocarcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 46-52.DOI:10.12015/issn.1674-8034.2022.09.009

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