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Abdominal Radiology

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22-09-2023 | Endometrial Cancer | Special Section: Quantitative Imaging

Diffusion kurtosis imaging with multiple quantitative parameters for predicting microsatellite instability status of endometrial carcinoma

Authors: Qingling Song, Wan Dong, Shifeng Tian, Lizhi Xie, Lihua Chen, Qiang Wei, Ailian Liu

Published in: Abdominal Radiology | Issue 12/2023

Abstract

Purpose

To explore the value of Diffusion kurtosis imaging (DKI) with multiple quantitative parameters in predicting microsatellite instability (MSI) status in endometrial carcinoma (EC).

Methods

Data of 38 patients with EC were retrospectively analyzed, including 12 MSI and 26 microsatellite stability (MSS). All patients underwent preoperative 1.5T MR examination. The quantitative values of the DKI sequence in the tumor parenchyma of the two groups, including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), fractional anisotropy of kurtosis (FAk), mean diffusivity (MD), axial diffusivity (Da), and radial diffusivity (Dr) were measured by two observers, respectively.

Results

The MK, Ka, Kr, FA, FAk, MD, Da, and Dr values of the MSI group were 1.074 ± 0.162, 1.253 ± 0.229, 0.886 ± 0.205, 0.207 ± 0.041, 0.397 ± 0.129, 0.890 ± 0.158 μm²/ms, 1.083 ± 0.218 μm²/ms, and 0.793 ± 0.133 μm²/ms, and 0.956 (0.889,1.002), 1.048 ± 0.211, 0.831 ± 0.099, 0.188 ± 0.061, 0.334 (0.241,0.410), 1.043 ± 0.217 μm²/ms, 1.235 ± 0.229 μm²/ms, and 0.946 ± 0.215 μm²/ms in the MSS group. The MK and Ka values of the MSI group were higher than those of the MSS group (P<0.05), while the MD and Dr values were lower than those of the MSS group (P<0.05). The AUC of MK, Ka, MD, and Dr values in predicting MSI status of EC was 0.763, 0.729, 0.731, 0.748, respectively. The sensitivity was 58.3%, 50.0%, 65.4%, 61.5%, and the specificity was 96.2%, 92.3%, 75.0%, 83.3%, respectively.

Conclusion

DKI can provide multiple quantitative parameters for predicting the MSI status of EC, and assist gynecologist to optimize the treatment plan for the patients.

Tamura K, Kaneda M, Futagawa M, Takeshita M, Kim S, Nakama M, Kawashita N, Tatsumi-Miyajima J (2019) Genetic and genomic basis of the mismatch repair system involved in Lynch syndrome. Int J Clin Oncol. Sep;24(9):999-1011. doi: https://doi.org/10.1007/s10147-019-01494-y. CrossRefPubMed

Kane AM, Fennell LJ, Liu C, Borowsky J, McKeone DM, Bond CE, Kazakoff S, Patch AM, Koufariotis LT, Pearson J, Waddell N, Leggett BA, Whitehall VLJ (2020) Alterations in signaling pathways that accompany spontaneous transition to malignancy in a mouse model of BRAF mutant microsatellite stable colorectal cancer. Neoplasia. Feb;22(2):120-128. doi: https://doi.org/10.1016/j.neo.2019.12.002. CrossRefPubMedPubMedCentral

Greenberg A, Kariv R, Solar I, Hershkovitz D (2020) Geographic Heterogeneity for Mismatch Repair Proteins Is Associated with Defects in DNA Repair. Isr Med Assoc J. Jan;22(1):32-36. PMID: 31927803. PubMed

Brooks RA, Fleming GF, Lastra RR, Lee NK, Moroney JW, Son CH, Tatebe K, Veneris JL (2019) Current recommendations and recent progress in endometrial cancer. CA Cancer J Clin. Jul;69(4):258-279. doi: https://doi.org/10.3322/caac.21561. CrossRefPubMed

Wadee R, Grayson W (2019) A potpourri of pathogenetic pathways in endometrial carcinoma with a focus on Lynch Syndrome. Ann Diagn Pathol. Apr;39:92-104. doi: https://doi.org/10.1016/j.anndiagpath.2019.02.003 CrossRefPubMed

Luchini C, Bibeau F, Ligtenberg MJL, Singh N, Nottegar A, Bosse T, Miller R, Riaz N, Douillard JY, Andre F, Scarpa A (2019) ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: a systematic review-based approach. Ann Oncol. Aug 1;30(8):1232-1243. doi: https://doi.org/10.1093/annonc/mdz116. CrossRefPubMed

Timmerman S, Van Rompuy AS, Van Gorp T, Vanden Bempt I, Brems H, Van Nieuwenhuysen E, Han SN, Neven P, Victoor J, Laenen A, Vergote I (2020) Analysis of 108 patients with endometrial carcinoma using the PROMISE classification and additional genetic analyses for MMR-D. Gynecol Oncol. Apr;157(1):245-251. doi: https://doi.org/10.1016/j.ygyno.2020.01.019. CrossRefPubMed

Silveira AB, Bidard FC, Kasperek A, Melaabi S, Tanguy ML, Rodrigues M, Bataillon G, Cabel L, Buecher B, Pierga JY, Proudhon C, Stern MH (2020) High-Accuracy Determination of Microsatellite Instability Compatible with Liquid Biopsies. Clin Chem; 66:606-13. doi: https://doi.org/10.1093/clinchem/hvaa013. CrossRefPubMed

Hill BL, Graf RP, Shah K, Danziger N, Lin DI, Quintanilha J, Li G, Haberberger J, Ross JS, Santin AD, Slomovitz B, Elvin JA, Eskander RN (2023) Mismatch repair deficiency, next-generation sequencing-based microsatellite instability, and tumor mutational burden as predictive biomarkers for immune checkpoint inhibitor effectiveness in frontline treatment of advanced stage endometrial cancer. Int J Gynecol Cancer. Apr 3;33(4):504-513. doi: https://doi.org/10.1136/ijgc-2022-004026 CrossRefPubMedPubMedCentral

10.

Abu-Rustum NR, Yashar CM, Bradley K et al (2021) NCCN Guidelines® insights: uterine neoplasms, version 3.2021. J Natl Compr Canc Netw 19:888–895. doi: https://doi.org/10.6004/jnccn.2021.0038 CrossRefPubMed

11.

Concin N, Matias-Guiu X, Vergote I et al (2021) ESGO/ESTRO/ ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 31:12–39. doi: https://doi.org/10.1136/ijgc-2020-002230 CrossRefPubMed

12.

Bhosale P, Ramalingam P, Ma J, Iyer R, Soliman P, Frumovitz M, Kundra V (2017) Can reduced field-of-view diffusion sequence help assess microsatellite instability in FIGO stage 1 endometrial cancer? J Magn Reson Imaging. Apr;45(4):1216-1224. doi: https://doi.org/10.1002/jmri.25427. CrossRefPubMed

13.

Ahmed M, Al-Khafaji JF, Class CA, Wei W (2018) Ramalingam P, Wakkaa H, Soliman PT, Frumovitz M, Iyer RB, Bhosale PR. Can MRI help assess aggressiveness of endometrial cancer? Clin Radiol. Sep;73(9):833.e11-833.e18. doi: https://doi.org/10.1016/j.crad.2018.05.002. CrossRef

14.

Haopeng P, Xuefei D, Yan R, Zhenwei Y, Wei H, Ziyin W, Qungang S, Chaojie L, Linyan Y, Zhongmin W, Xiaoyuan F (2020) Diffusion kurtosis imaging differs between primary central nervous system lymphoma and high-grade glioma and is correlated with the diverse nuclear-to-cytoplasmic ratio: a histopathologic, biopsy-based study. Eur Radiol. Apr;30(4):2125-2137. doi: https://doi.org/10.1007/s00330-019-06544-7. CrossRefPubMed

15.

Bickelhaupt S, Jaeger PF, Laun FB, Lederer W, Daniel H, Kuder TA, Wuesthof L, Paech D, Bonekamp D, Radbruch A, Delorme S, Schlemmer HP, Steudle FH, Maier-Hein KH (2018) Radiomics Based on Adapted Diffusion Kurtosis Imaging Helps to Clarify Most Mammographic Findings Suspicious for Cancer. Radiology. Jun;287(3):761-770. doi: https://doi.org/10.1148/radiol.2017170273. CrossRefPubMed

16.

Yoon JH, Lee JM, Lee KB, Kim D, Kabasawa H, Han JK (2019) Comparison of monoexponential, intravoxel incoherent motion diffusion-weighted imaging and diffusion kurtosis imaging for assessment of hepatic fibrosis. Acta Radiol. Dec;60(12):1593-1601. doi: https://doi.org/10.1177/0284185119840219. CrossRefPubMed

17.

Abdulfatah E, Wakeling E, Sakr S, Al-Obaidy K, Bandyopadhyay S, Morris R, Feldman G, Ali-Fehmi R (2019) Molecular classification of endometrial carcinoma applied to endometrial biopsy specimens: Towards early personalized patient management. Gynecol Oncol. Sep;154(3):467-474. doi: https://doi.org/10.1016/j.ygyno.2019.06.012. CrossRefPubMed

18.

Ryan N, Wall J, Crosbie EJ, Arends M, Bosse T, Arif S, Faruqi A, Frayling I, Ganesan R, Hock YL, McMahon R, Manchanda R, McCluggage WG, Mukonoweshuro P, van Schalkwyk G, Side L, Smith JH, Tanchel B, Evans DG, Gilks CB, Singh N (2019) Lynch syndrome screening in gynaecological cancers: results of an international survey with recommendations for uniform reporting terminology for mismatch repair immunohistochemistry results. Histopathology. Dec;75(6):813-824. doi: https://doi.org/10.1111/his.13925. CrossRefPubMed

19.

Kahn RM, Gordhandas S, Maddy BP, Baltich Nelson B, Askin G, Christos PJ, Caputo TA, Chapman-Davis E, Holcomb K, Frey MK (2019) Universal endometrial cancer tumor typing: How much has immunohistochemistry, microsatellite instability, and MLH1 methylation improved the diagnosis of Lynch syndrome across the population? Cancer. Sep 15;125(18):3172-3183. doi: https://doi.org/10.1002/cncr.32203. CrossRefPubMed

20.

Yang G, Zheng RY, Jin ZS (2019) Correlations between microsatellite instability and the biological behaviour of tumours. J Cancer Res Clin Oncol. Dec;145(12):2891-2899. doi: https://doi.org/10.1007/s00432-019-03053-4. CrossRefPubMedPubMedCentral

21.

Ruz-Caracuel I, Ramón-Patino JL, López-Janeiro Á, Yébenes L, Berjón A, Hernández A, Gallego A, Heredia-Soto V, Mendiola M, Redondo A, Peláez-García A, Hardisson D (2019) Myoinvasive Pattern as a Prognostic Marker in Low-Grade, Early-Stage Endometrioid Endometrial Carcinoma. Cancers (Basel). Nov 22;11(12):1845. doi: https://doi.org/10.3390/cancers11121845. CrossRefPubMed

22.

Dietmaier W, Büttner R, Rüschoff J. Mikrosatelliteninstabilität: Aktueller Überblick über Methoden und Anwendungen (2019) [Microsatellite instability: Review of methods and applications]. Pathologe. May;40(3):313-327. German. doi: https://doi.org/10.1007/s00292-019-0610-7. CrossRefPubMed

23.

Granata V, Fusco R, Setola SV, Palaia R, Albino V, Piccirillo M, Grimm R, Petrillo A, Izzo F (2019) Diffusion kurtosis imaging and conventional diffusion weighted imaging to assess electrochemotherapy response in locally advanced pancreatic cancer. Radiol Oncol. Jan 19;53(1):15-24. doi: https://doi.org/10.2478/raon-2019-0004. CrossRefPubMedPubMedCentral

24.

Yamada I, Sakamoto J, Kobayashi D, Miyasaka N, Wakana K, Oshima N, Wakabayashi A, Saida Y, Tateishi U, Eishi Y (2019) Diffusion kurtosis imaging of endometrial carcinoma: Correlation with histopathological findings. Magn Reson Imaging. Apr;57:337-346. doi: https://doi.org/10.1016/j.mri.2018.12.009. CrossRefPubMed

25.

Yue W, Meng N, Wang J, Liu W, Wang X, Yan M, Han D, Cheng J (2019) Comparative analysis of the value of diffusion kurtosis imaging and diffusion-weighted imaging in evaluating the histological features of endometrial cancer. Cancer Imaging. Feb 14;19(1):9. doi: https://doi.org/10.1186/s40644-019-0196-6. CrossRefPubMedPubMedCentral

26.

Chen T, Li Y, Lu SS, Zhang YD, Wang XN, Luo CY, Shi HB (2017) Quantitative evaluation of diffusion-kurtosis imaging for grading endometrial carcinoma: a comparative study with diffusion-weighted imaging. Clin Radiol. Nov;72(11):995.e11-995.e20. doi: https://doi.org/10.1016/j.crad.2017.07.004. CrossRefPubMed

27.

Song JC, Lu SS, Zhang J, Liu XS, Luo CY, Chen T (2020) Quantitative assessment of diffusion kurtosis imaging depicting deep myometrial invasion: a comparative analysis with diffusion-weighted imaging. Diagn Interv Radiol. Mar;26(2):74-81. doi: https://doi.org/10.5152/dir.2019.18366. CrossRefPubMedPubMedCentral

28.

Tan Y, Zhang H, Wang X, Qin J, Wang L, Yang G, Yan H (2019) Comparing the value of DKI and DTI in detecting isocitrate dehydrogenase genotype of astrocytomas. Clin Radiol. Apr;74(4):314-320. doi: https://doi.org/10.1016/j.crad.2018.12.004. CrossRefPubMed

29.

Hempel JM, Brendle C, Bender B, Bier G, Kraus MS, Skardelly M, Richter H, Eckert F, Schittenhelm J, Ernemann U, Klose U (2019) Diffusion kurtosis imaging histogram parameter metrics predicting survival in integrated molecular subtypes of diffuse glioma: An observational cohort study. Eur J Radiol. Mar;112:144-152. doi: https://doi.org/10.1016/j.ejrad.2019.01.014. CrossRefPubMed

30.

Mastropietro A, Rizzo G, Fontana L, Figini M, Bernardini B, Straffi L, Marcheselli S, Ghirmai S, Nuzzi NP, Malosio ML, Grimaldi M (2019) Microstructural characterization of corticospinal tract in subacute and chronic stroke patients with distal lesions by means of advanced diffusion MRI. Neuroradiology. Sep;61(9):1033-1045. doi: https://doi.org/10.1007/s00234-019-02249-2. CrossRefPubMedPubMedCentral

31.

Akhtar M, Al Hyassat S, Elaiwy O, Rashid S, Al-Nabet ADMH (2019) Classification of Endometrial Carcinoma: New Perspectives Beyond Morphology. Adv Anat Pathol. Nov;26(6):421-427. doi: https://doi.org/10.1097/PAP.0000000000000251. CrossRefPubMed

32.

Doghri R, Houcine Y, Boujelbène N, Driss M, Charfi L, Abbes I, Mrad K, Sellami R (2019) Mismatch Repair Deficiency in Endometrial Cancer: Immunohistochemistry Staining and Clinical Implications. Appl Immunohistochem Mol Morphol. Oct;27(9):678-682. doi: https://doi.org/10.1097/PAI.0000000000000641. CrossRefPubMed

33.

Travaglino A, Raffone A, Stradella C, Esposito R, Moretta P, Gallo C, Orlandi G, Insabato L, Zullo F (2020) Impact of endometrial carcinoma histotype on the prognostic value of the TCGA molecular subgroups. Arch Gynecol Obstet. Jun;301(6):1355-1363. doi: https://doi.org/10.1007/s00404-020-05542-1. CrossRefPubMed

34.

iang JX, Zhao JL, Zhang Q, Qing JF, Zhang SQ, Zhang YM, Wu XH (2018) Endometrial carcinoma: diffusion-weighted imaging diagnostic accuracy and correlation with Ki-67 expression. Clin Radiol. Apr;73(4):413.e1-413.e6. doi: https://doi.org/10.1016/j.crad.2017.11.011. CrossRefPubMed

35.

Tian S, Liu A, Zhu W, Li Y, Chen L, Chen A, Shen J, Song Q, Wei Q (2017) Difference in Diffusion-Weighted Magnetic Resonance Imaging and Diffusion Tensor Imaging Parameters Between Endometrioid Endometrial Adenocarcinoma and Uterine Serous Adenocarcinoma: A Retrospective Study. Int J Gynecol Cancer. Oct;27(8):1708-1713. doi: https://doi.org/10.1097/IGC.0000000000001054. CrossRefPubMed

36.

Yu J, Xu Q, Song JC, Li Y, Dai X, Huang DY, Zhang L, Li Y, Shi HB (2017) The value of diffusion kurtosis magnetic resonance imaging for assessing treatment response of neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Eur Radiol. May;27(5):1848-1857. doi: https://doi.org/10.1007/s00330-016-4529-6. CrossRefPubMed

37.

Shi J, Yang S, Wang J, Huang S, Yao Y, Zhang S, Zhu W, Shao J (2019) Detecting normal pediatric brain development with diffusional kurtosis imaging. Eur J Radiol. Nov;120:108690. doi: https://doi.org/10.1016/j.ejrad.2019.108690. CrossRefPubMed

38.

Li L, Zhu W, Chen W, Fang J, Li J (2017) The study of the intervertebral disc microstructure in matured rats with diffusion kurtosis imaging. Magn Reson Imaging. Oct;42:101-106. doi: https://doi.org/10.1016/j.mri.2017.06.010. CrossRefPubMed

39.

Gao J, Feng ST, Wu B, Gong N, Lu M, Wu PM, Wang H, He X (2015) Huang B. Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic-clonic seizure: a voxel-based diffusional kurtosis imaging study. J Magn Reson Imaging. Apr;41(4):1088-95. doi: https://doi.org/10.1002/jmri.24647. CrossRefPubMed

40.

Luo X, Li Y, Shang Q, Liu H, Song L (2019) Role of Diffusional Kurtosis Imaging in Evaluating the Efficacy of Transcatheter Arterial Chemoembolization in Patients with Liver Cancer. Cancer Biother Radiopharm. Dec;34(10):614-620. doi: https://doi.org/10.1089/cbr.2019.2878. CrossRefPubMed

41.

Zhang J, Jiang J, Zhao L, Zhang J, Shen N, Li S, Guo L, Su C, Jiang R, Zhu W (2019) Survival prediction of high-grade glioma patients with diffusion kurtosis imaging. Am J Transl Res. Jun 15;11(6):3680-3688. PubMedPubMedCentral

42.

Goryawala MZ, Heros DO, Komotar RJ, Sheriff S, Saraf-Lavi E, Maudsley AA (2018) Value of diffusion kurtosis imaging in assessing low-grade gliomas. J Magn Reson Imaging. Dec;48(6):1551-1558. doi: https://doi.org/10.1002/jmri.26012. CrossRefPubMedPubMedCentral

Title: Diffusion kurtosis imaging with multiple quantitative parameters for predicting microsatellite instability status of endometrial carcinoma
Authors: Qingling Song
Wan Dong
Shifeng Tian
Lizhi Xie
Lihua Chen
Qiang Wei
Ailian Liu
Publication date: 22-09-2023
Publisher: Springer US
Keywords: Endometrial Cancer
Endometrial Cancer
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Abdominal Radiology / Issue 12/2023
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-023-04041-6

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