Top

European Radiology

Published in:

01-05-2018 | Magnetic Resonance

Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio

Authors: Xiangsheng Li, Ping Wang, Dechang Li, Hongxian Zhu, Limin Meng, Yunlong Song, Lizhi Xie, Jianping Zhu, Tao Yu

Published in: European Radiology | Issue 5/2018

Abstract

Objectives

To investigate if intravoxel incoherent motion (IVIM) MR imaging can predict the tumour-stroma ratio (TSR) in patients with early cervical carcinoma.

Methods

Fifty-four patients with early cervical carcinoma were prospectively enrolled into this study. All patients underwent IVIM imaging and parameters including D, D* and f value were measured. The tumours were classified into stroma-rich and stroma-poor group according to TSR, and comparisons of IVIM parameters between two groups were performed. The relationships between IVIM parameters and TSR were analysed by using a multivariate multi-regression analysis.

Results

D and f values were significantly lower in stroma-poor tumours than in stroma-rich tumours (p=0.02, 0.04), while the difference in D* value between two groups didn't achieve statistical significance (p=0.09). The areas under ROC curves of D and f values in discriminating stroma-rich and stroma-poor tumours were 0.835 (95%CI=0.616~0.905) and 0.686 (95%CI=0.575~0.798). In multiple linear regression analysis, D value, pathologic type, histologic grade, tumour size and f value were independently correlated with TSR of cervical carcinoma.

Conclusions

D and f values are independently correlated with TSR of cervical carcinoma and have the potential for quantitative measurement of TSR.

Key Points

• TSR is a recognized independent prognostic factor in many solid tumours.

• D and f values measured by IVIM MRI are independently correlated with TSR while D* is not.

• IVIM offers the potential to predict TSR.

Mesker WE, Junggeburt JM, Szuhai K et al (2007) The carcinoma-stromal ratio of colon carcinoma is an independent factor for survival compared to lymph node status and tumour stage. Cell Oncol 29:387–398PubMedPubMedCentral

Liu J, Liu J, Li J et al (2014) tumour-stroma ratio is an independent predictor for survival in early cervical carcinoma. Gynecol Oncol 132:81–86CrossRefPubMed

de Kruijf EM, van Nes JG, van de Velde CJ et al (2011) tumour-stroma ratio in the primary tumour is a prognostic factor in early breast cancer patients, especially in triple-negative carcinoma patients. Breast Cancer Res Treat 125:687–696CrossRefPubMed

Ahn S, Cho J, Sung J et al (2012) The prognostic significance of tumour-associated stroma in invasive breast carcinoma. Tumour Biol 33:1573–1580CrossRefPubMed

Gremonprez F, Descamps B, Izmer A et al (2015) Pretreatment with VEGF(R)-inhibitors reduces interstitial fluid pressure, increases intraperitoneal chemotherapy drug penetration, and impedes tumour growth in a mouse colorectal carcinomatosis model. Oncotarget 6:29889–29900CrossRefPubMedPubMedCentral

Wu J, Liang C, Chen M, Su W (2016) Association between tumour-stroma ratio and prognosis in solid tumour patients: a systematic review and meta-analysis. Oncotarget 7:68954–68965PubMedPubMedCentral

Zhang R, Song W, Wang K, Zou S (2017) Tumour-stroma ratio(TSR) as a potential novel predictor of prognosis in digestive system cancers: A meta-analysis. Clin Chim Acta 472:64–68CrossRefPubMed

Roeke T, Sobral-Leite M, Dekker TJA (2017) The prognostic value of the tumour-stroma ratio in primary operable invasive cancer of the breast: a validation study. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-017-4445-8

Zhang XL, Jiang C, Zhang ZX, Liu F, Zhang F, Cheng YF (2014) The tumour-stroma ratio is an independent predictor for survival in nasopharyngeal cancer. Oncol Res Treat 37:480–484CrossRefPubMed

10.

Ko ES, Han BK, Kim RB et al (2014) Apparent diffusion coefficient in estrogen receptor-positive invasive ductal breast carcinoma: correlations with tumour-stroma ratio. Radiology 271:30–37CrossRefPubMed

11.

Che S, Zhao X, Ou Y et al (2016) Role of the intravoxel incoherent motion diffusion weighted imaging in the pre-treatment prediction and early response monitoring to neoadjuvant chemotherapy in locally advanced breast cancer. Medicine (Baltimore) 95:e2420–e2432CrossRef

12.

Le Bihan D, Breton E, Lallemand D et al (1986) MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 161:401–407CrossRefPubMed

13.

Zhang G, Wang S, Wen D et al (2016) Comparison of non-Gaussian and Gaussian diffusion models of diffusion weighted imaging of rectal cancer at 3.0 T MRI. Sci Rep 6:38782–38791CrossRefPubMedPubMedCentral

14.

Klauss M, Mayer P, Maier-Hein K et al (2016) IVIM-diffusion-MRI for the differentiation of solid benign and malignant hypervascular liver lesions-evaluation with two different MR scanners. Eur J Radiol 85:1289–1294CrossRefPubMed

15.

Lee YJ, Kim SH, Kang BJ et al (2017) Intravoxel incoherent motion (IVIM)-derived parameters in diffusion-weighted MRI: associations with prognostic factors in invasive ductal carcinoma. J Magn Reson Imaging 45:1394–1406CrossRefPubMed

16.

Ma C, Li Y, Wang L et al (2017) Intravoxel incoherent motion DWI of the pancreatic adenocarcinomas: monoexponential and biexponential apparent diffusion parameters and histopathological correlations. Cancer Imaging 28:12–21CrossRef

17.

Xu XQ, Choi YJ, Sung YS et al (2016) Intravoxel incoherent motion MR imaging in the head and neck: correlation with dynamic contrast-enhanced MR imaging and diffusion-weighted imaging. Korean J Radiol 17:641–649CrossRefPubMedPubMedCentral

18.

Caldas-Magalhaes J, Kasperts N, Kooij N et al (2012) Validation of imaging with pathology in laryngeal cancer: accuracy of the registration methodology. Int J Radiat Oncol Biol Phys 82:e289–e298CrossRefPubMed

19.

Odida M, Schmauz R (1996) Classification and grading of squamous cell carcinoma of the cervix. East Afr Med J 73:S9–S10PubMed

20.

Lin L (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics. 45:255–268CrossRefPubMed

21.

Lemke A, Stieltjes B, Schad LR, Laun FB (2011) Toward an optimal distribution of b values for intravoxel incoherent motion imaging. Magn Reson Imaging 29:766–776CrossRefPubMed

22.

Correia MM, Carpenter TA, Williams GB (2009) Looking for the optimal DTI acquisition scheme given a maximum scan time: are more b-values a waste of time? Magn Reson Imaging 27:163–175CrossRefPubMed

23.

Wu WC, Yang SC, Chen YF, Tseng HM, My PC (2017) Simultaneous assessment of cerebral blood volume and diffusion heterogeneity using hybrid IVIM and DK MR imaging: initial experience with brain tumours. Eur Radiol 27:306–314CrossRefPubMed

24.

Driessen JP, Caldas-Magalhaes J, Janssen LM et al (2014) Diffusion-weighted MR imaging in laryngeal and hypopharyngeal carcinoma: association between apparent diffusion coefficient and histologic findings. Radiology 272:456–463CrossRefPubMed

25.

Lee EY, Yu X, Chu MM et al (2014) Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study. Eur Radiol 24:1506–1513CrossRefPubMed

26.

Zhu L, Zhu L, Shi H et al (2016) Evaluating early response of cervical cancer under concurrent chemo-radiotherapy by intravoxel incoherent motion MR imaging. BMC Cancer 16:79–87CrossRefPubMedPubMedCentral

27.

Wang YC, Hu S, Hu XM et al (2015) Intravoxel incoherent motion magnetic resonance imaging for diagnosis of cervical cancer and evaluation of response of uterine cervical cancer to radiochemotherapy: a pilot study. Oncology and Translational Medicine 1:P164–P170

28.

Winfield JM, Orton MR, Collins DJ et al (2017) Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI. Eur Radiol 27:627–636CrossRefPubMed

29.

Aoyagi T, Shuto K, Okazumi S et al (2012) Apparent diffusion coefficient correlation with oesophageal tumour stroma and angiogenesis. Eur Radiol 22:1172–1177CrossRefPubMed

30.

Partridge SC, Mullins CD, Kurland BF et al (2010) Apparent diffusion coefficient values for discriminating benign and malignant breast MRI lesions: effects of lesion type and size. AJR Am J Roentgenol 194:1664–1673CrossRefPubMed

31.

Liu Y, Bai R, Sun H et al (2009) Diffusion weighted imaging in predicting and monitoring the response of uterine cervical cancer to combined chemoradiation. Clinical Radiology 64:1067–1074CrossRefPubMed

32.

Kuang F, Ren J, Zhong Q et al (2013) The value of apparent diffusion coefficient in the assessment of cervical cancer. Eur Radiol 23:1050–1058CrossRefPubMed

33.

Barbieri S, Donati OF, Froehlich JM, Thoeny HC (2016) Impact of the calculation algorithm on biexponential fitting of diffusion-weighted MRI in upper abdominal organs. Magn Reson Med 75:2175–2184CrossRefPubMed

34.

Jerome NP, Miyazaki K, Collins DJ et al (2017) Repeatability of derived parameters from histograms following non-Gaussian diffusion modelling of diffusion-weighted imaging in a paediatric oncological cohort. Eur Radiol 27:345–353CrossRefPubMed

35.

Lin M, Yu X, Chen Y et al (2017) Contribution of mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging in the diagnosis and differentiation of uterine cervical carcinoma. Eur Radiol 27:2400–2410CrossRefPubMed

36.

Verma S, Sarkar S, Young J et al (2016) Evaluation of the impact of computed high b-value diffusion-weighted imaging on prostate cancer detection. Abdom Radiol (NY) 41:934–945CrossRef

37.

Becker AS, Perucho JA, Wurnig MC et al (2017) Assessment of cervical cancer with a parameter-free intravoxel incoherent motion imaging algorithm. Korean J Radiol 18:510–518CrossRefPubMedPubMedCentral

Title: Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio
Authors: Xiangsheng Li
Ping Wang
Dechang Li
Hongxian Zhu
Limin Meng
Yunlong Song
Lizhi Xie
Jianping Zhu
Tao Yu
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5183-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 5/2018

Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure

Anatomical Road Mapping Using CT and MR Enterography for Ultrasound Molecular Imaging of Small Bowel Inflammation in Swine

Metal artifact reduction MRI of total ankle arthroplasty implants

Development of pumping emulsification device with glass membrane to form ideal lipiodol emulsion in transarterial chemoembolization

Evaluation of vertebral body fractures using susceptibility-weighted magnetic resonance imaging

Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment