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• Clinical Article •
Study the value of reduced field-of-view diffusion kurtosis imaging in histological evaluation of endometrial adenocarcinoma
ZHU Liuhong  LU Weihong  WANG Yanwei  WU Puye  WANG Funan  LIU Hao  ZHOU Jianjun 

Cite this article as: ZHU L H, LU W H, WANG Y W, et al. Study the value of reduced field-of-view diffusion kurtosis imaging in histological evaluation of endometrial adenocarcinoma[J]. Chin J Magn Reson Imaging, 2025, 16(2): 77-82. DOI:10.12015/issn.1674-8034.2025.02.012.


[Abstract] Objective To explore the potential performance of reduced field-of-view diffusion kurtosis imaging (rFOV-DKI) in the differentiating the different histological grades of endometrial adenocarcinoma.Materials and Methods A total of 48 patients with pathologically confirmed endometrial adenocarcinoma were enrolled in our study after getting institutional review board approval. According to the two-rank classification method of the International Federation of Gynecology and Obstetrics (FIGO), the participants were divided to low-grade group (G1, G1-2 and G2, n = 30) and high-grade group (G3, n = 18). All participants underwent contrast enhancement MR examinations including routine sequences and additional rFOV-DKI sequence on a 3.0 T MRI scanner. The data was postprocessed by the functional tool on the workstation (AW4.6, GE Healthcare). With the reference of sagittal T2WI images, the lesion ROI (region of interest) was outlined. Derived parameters of DKI, including mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr), mean kurtosis (MK), axial kurtosis (Ka), and radial kurtosis (Kr) were all calculated. The DKI parameters of low-grade group and high-grade group were compared. The receiver operating characteristic (ROC) curve was used to evaluate each parameter's diagnostic performance.Results Mean values of MD, Da and Dr of low-grade group [(0.93 ± 0.08) µm2/ms, (1.14 ± 0.10) µm2/ms, (0.83 ± 0.08) µm2/ms] were significantly higher than those of high-grade group [(0.80 ± 0.08) µm2/ms, (1.05 ± 0.07) µm2/ms, (0.74 ± 0.06) µm2/ms; all P < 0.05]. While mean values of MK, Ka and Kr of low-grade group (1.15 ± 0.10, 1.36 ± 0.10, 0.97 ± 0.13) were significantly lower than those of high-grade group (1.33 ± 0.11, 1.64 ± 0.11, 1.08 ± 0.09). The Ka values had the highest diagnostic accuracy in differentiating low-grade group from high-grade group, AUC = 0.98 (95% CI: 0.89 to 1.00), followed by MK [AUC = 0.90 (95% CI: 0.78 to 0.97)] and MD [AUC is 0.88 (95% CI: 0.76 to 0.96)]. There were no significant differences between AUCs of MK and Ka (Z = 1.81, P = 0.07), and AUCs of MK and MD (Z = 0.53, P = 0.59), while significant differences were found between that of Ka and MD (Z = 2.40, P = 0.02). Ka performed best (sensitivity: 100%, specificality: 90%) in the differentiation between low-grade group from high-grade group among all DKI derived parameters.Conclusions Kurtosis indices from rFOV-DKI based on the non-Gaussian diffusion-weighted model can be acted as a potential tool in the grade differentiation of endometrial adenocarcinoma, and can be a useful compensation to the conventional MRI.
[Keywords] endometrial adenocarcinoma；magnetic resonance imaging；reduced field-of-view diffusion kurtosis imaging；histological grade；mean kurtosis；axial kurtosis

ZHU Liuhong1   LU Weihong2   WANG Yanwei3   WU Puye4   WANG Funan1   LIU Hao1, 5*   ZHOU Jianjun1, 5  

1 Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, China

2 Department of Gynaecology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, China

3 Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361012, China

4 Department of Magnetic Resonance Research, GE Healthcare, Beijing 100176, China

5 Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

Corresponding author: LIU H, E-mail: liuhaozsxm@163.com

Conflicts of interest   None.

Received  2024-07-29
Accepted  2025-01-10
DOI: 10.12015/issn.1674-8034.2025.02.012
Cite this article as: ZHU L H, LU W H, WANG Y W, et al. Study the value of reduced field-of-view diffusion kurtosis imaging in histological evaluation of endometrial adenocarcinoma[J]. Chin J Magn Reson Imaging, 2025, 16(2): 77-82. DOI:10.12015/issn.1674-8034.2025.02.012.

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