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  • Title: Multiple mathematical models of diffusion-weighted imaging for endometrial cancer characterization: Correlation with prognosis-related risk factors.
    Author: Zhang Q, Ouyang H, Ye F, Chen S, Xie L, Zhao X, Yu X.
    Journal: Eur J Radiol; 2020 Sep; 130():109102. PubMed ID: 32673928.
    Abstract:
    PURPOSE: To investigate mono-exponential, bi-exponential, and stretched-exponential models of diffusion-weighted imaging (DWI) for evaluation of prognosis-related risk factors of endometrial cancer (EC). METHOD: Sixty-one consecutive patients with EC who preoperatively underwent pelvic MRI with multiple b value DWI between September 2016 and May 2018 were enrolled. The apparent-diffusion-coefficient (ADC), bi-exponential model parameters (D, D* and f) and stretched-exponential model parameters (DDC and α) were measured and compared to analyze the following prognosis-related risk factors confirmed by pathology: histological grade, depth of myometrial invasion, cervical stromal infiltration (CSI) and lymphovascular invasion (LVSI). A stepwise multilvariate logistic regression and the receiver operating characteristic (ROC) curves were performed for further statistical analysis. RESULTS: Lower ADC, D, f, and DDC were observed in tumor with high grade compared with a low-grade group, and the largest area under curve (AUC) was obtained when combining f and DDC values. ADC, D, f, DDC, and α were significantly different in patients with deep myometrial invasion (DMI) compared to those without DMI; the combination of f, DDC and α showed the highest AUC. Significantly different ADC and f were found between patients' presence and absence CSI; the f values showed the highest diagnostic performance with an AUC of 0.825. Regarding the LVSI, ADC, D*, f, and DDC were significantly lower in tumors with LVSI compared to those without LVSI; the combination of f and DDC showed the largest AUC. CONCLUSION: Multiple mathematical DWI models are a useful approach for the prediction of prognosis-related risk factors in EC.
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