Amide Proton Transfer-Weighted Imaging Combined With Intravoxel Incoherent Motion for Evaluating Microsatellite...

Area of Science:

• Oncology
• Radiology
• Biomedical Imaging

Background:

• Microsatellite instability (MSI) in endometrial cancer (EC) arises from DNA mismatch repair defects, leading to mutations and tumor development.
• Preoperative MSI prediction is crucial for tailoring personalized and precise treatment plans for EC patients.

Purpose of the Study:

• To evaluate the efficacy of amide proton transfer weighting (APTw) imaging combined with intravoxel incoherent motion (IVIM) for assessing MSI in EC.
• To determine if these imaging techniques can noninvasively predict MSI status in EC patients.

Main Methods:

• A retrospective study involving 71 EC patients (12 MSI, 22 MSS).
• Utilized 3.0T MRI with IVIM, diffusion-weighted imaging (DWI), and APTw sequences.
• Calculated and compared parameters including APT value, ADC, D, D*, and f between MSI and MSS groups.

Main Results:

• Patients with MSI showed significantly higher APT and D* values compared to the MSS group.
• Conversely, ADC, D, and f values were significantly lower in the MSI group.
• Multivariate analysis identified APT and D* as independent predictors of MSI status, with their combination achieving the highest diagnostic efficacy (AUC = 0.973).

Conclusions:

• The combination of APTw and IVIM imaging offers a promising noninvasive method for the clinical assessment of MSI in EC.
• This approach can aid in preoperative prediction and guide personalized treatment decisions for EC patients.