Risk Stratification Prediction of Endometrial Cancer Using Microstructural Mapping Based on Time-Dependent Diffusion...

Area of Science:

• Radiology
• Oncology
• Biomedical Engineering

Background:

• Time-dependent diffusion MRI (t_d-dMRI) shows promise for microstructural characterization.
• Its utility in imaging endometrioid endometrial adenocarcinoma (EEA) requires further investigation.

Purpose of the Study:

• To evaluate the diagnostic performance of t_d-dMRI in assessing microstructural features of EEA.
• To correlate t_d-dMRI parameters with risk stratification and proliferation status in EEA patients.

Main Methods:

• t_d-dMRI data acquired using pulsed gradient spin echo and oscillating gradient spin echo sequences.
• Microstructural parameters (cell diameter, V_in, cellularity, D_ex) fitted using the IMPULSED model.
• Comparison of parameters between low/high-risk and low/high-proliferation groups; diagnostic performance assessed via ROC and logistic regression.

Main Results:

• High-risk and high-proliferation groups showed significantly lower diameter, D_ex, ADC_PGSE, ADC_N1, ADC_N2, and higher cellularity, ΔADC1, ΔADC2.
• Cellularity, ΔADC1, and ΔADC2 demonstrated excellent diagnostic efficacy for risk and proliferation.
• Cellularity was an independent predictor for risk stratification, correlating with histopathologic cell density.

Conclusions:

• t_d-dMRI-based microstructural mapping can noninvasively probe EEA pathologic characteristics.
• This technique offers valuable contributions to surgical guidance and clinical decision-making for EEA.
• Cellularity derived from t_d-dMRI is a key imaging biomarker for EEA risk and proliferation.