Related Experiment Video
Updated: Aug 22, 2026
Assessment of Global DNA Double-Strand End Resection using BrdU-DNA Labeling coupled with Cell Cycle Discrimination Imaging
Published on: April 28, 2021
Restriction spectrum imaging and diffusion kurtosis imaging for evaluating proliferation status in cervical cancer
Wenling Liu1, Huijia Yin1, Beiran Wang1
1Department of MR, The First Affiliated Hospital, Henan Medical University, Weihui, China.
Objectives:
To explore the diagnostic efficacy of three-compartment restriction spectrum imaging (RSI) and diffusion kurtosis imaging (DKI) in predicting proliferative status in patients with cervical cancer (CC).
Methods:
A total of 100 patients diagnosed with CC were enrolled in the present study. All patients were stratified into the high- (Ki-67 > 50%, n = 58) and low-proliferation group (Ki-67 ≤ 50%, n = 42). Quantitative parameters derived from RSI (f 1, f 2, f 3), DKI (MD, MK), and conventional diffusion-weighted imaging (DWI, ADC) were compared between the two groups. Logistic regression (LR) analysis was performed to screen independent predictors and construct an integrated diagnostic model. The area under the receiver operating characteristic curve (AUC) was calculated to quantify the diagnostic performance, and the DeLong test was adopted for pairwise comparisons of AUC values.
Results:
Compared with patients in the low-proliferation group, those in the high- proliferation group presented significantly lower f 1, MD, and ADC values, along with markedly elevated MK, f 2, and f 3 values (all P < 0.05). The corresponding AUC values were 0.84, 0.76, 0.76, 0.87, 0.79, and 0.80, respectively. LR analysis identified f 2, MD, MK, and ADC as independent predictors. The integrated diagnostic model based on these four independent predictors yielded optimal diagnostic performance, with an AUC of 0.94 (95% CI: 0.87-0.98). DeLong analysis revealed that this integrated model significantly outperformed all single imaging parameters (f 1, f 2, f 3, MD, MK, ADC), with Z values of 1.99, 3.11, 2.58, 4.09, 2.46, and 4.05 (all P < 0.05). Internal bootstrap validation confirmed the excellent stability of the combined model, with a corrected AUC of 0.92 (95% CI: 0.90-0.93).
Conclusion:
RSI, DKI and conventional DWI are all reliable imaging techniques for evaluating proliferative status in CC. The combined application of f 2, MD, MK, and ADC parameters serves as a promising non-invasive biomarker strategy for guiding individualized treatment decision-making and prognostic stratification in patients with CC.
