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A preliminary study on quantitative parameter prediction of HIF-1α in pancreatic ductal adenocarcinoma using diffusion kurtosis imaging
WANG Fangqing  CHEN Yinghui  SUN Yang  WANG Yong  YU Dexin 

Cite this article as: WANG F Q, CHEN Y H, SUN Y, et al. A preliminary study on quantitative parameter prediction of HIF-1α in pancreatic ductal adenocarcinoma using diffusion kurtosis imaging[J]. Chin J Magn Reson Imaging, 2025, 16(5): 37-43. DOI:10.12015/issn.1674-8034.2025.05.006.


[Abstract] Objective To explore the value of diffusion kurtosis imaging (DKI) quantitative parameters in predicting the grading of hypoxia inducible factor-1α (HIF-1α) in pancreatic ductal adenocarcinoma (PDAC).Materials and Methods A retrospective analysis was conducted on the data of 61 PDAC patients who underwent preoperative 1.5 T MRI examination and were confirmed by surgical pathology. According to the postoperative pathological immunohistochemical score, the patients were divided into a HIF-1α low expression group (32 cases) and a HIF-1α high expression group (29 cases). Two radiologists measured the diffusion weighted imaging (DWI) quantitative parameters, including apparent diffusion coefficient (ADC), mean diffusion coefficient (MD), and mean kurtosis (MK), for two groups of lesions. Independent sample t-test Mann Whitney U test or chi square test were used to analyze the differences in clinical pathological data between two groups, and intra class correlation coefficient (ICC) was used to test the consistency of the measurements of each parameter value by two radiologists. Evaluate the discriminative power of statistically significant parameters through receiver operating characteristic (ROC) curves, DeLong test, Net reclassification improvement and integrated discrimination improvement indicators.Results The low tumor differentiation in the high HIF-1α expression group was significantly higher than that in the low HIF-1α expression group (P = 0.031). The quantitative MRI data measured by two radiologists showed good consistency (ICC values > 0.75). The MD value of the HIF-1α high expression group [(1.17 ± 0.26) × 10-3 mm2/s] was lower than that of the HIF-1α low expression group [(1.52 ± 0.39) × 10-3 mm2/s], the MK value of the HIF-1α high expression group (0.72 ± 0.11) was higher than that of the HIF-1α low expression group (0.61 ± 0.11), the difference between the two groups was statistically significant (all P < 0.001). No statistically significant difference in ADC values between the two groups. The AUC, sensitivity, and specificity of MD value, MK value, MD value + MK value, and MD value + MK value + differentiation degree in predicting high and low HIF-1α expression are 0.751, 74.7%, 64.8%; 0.814, 84.4%, 72.4%; 0.862, 82.8%, 78.7%; 0.872, 78.1%, 86.2%. The DeLong test showed that the predictive power of MD value + MK value + differentiation degree was only statistically different from MD value (P = 0.037), no statistically significant difference from other parameters (P > 0.05). The NRI and IDI results showed that MD value + MK value + differentiation degree significantly improved the predictive ability of HIF-1α, and was superior to MD value, MK value and MD value + MK value (P < 0.05).Conclusions The combination of MD value, MK value and tumor differentiation degree can help predict different HIF-1α expression in PDAC tumors, providing a basis for preoperative risk stratification and personalized treatment.
[Keywords] pancreatic ductal adenocarcinoma；magnetic resonance imaging；diffusion kurtosis imaging；diffusion-weighted imaging；hypoxia-inducible factor-1α

WANG Fangqing1   CHEN Yinghui1   SUN Yang2   WANG Yong3   YU Dexin1*  

1 Department of Radiology, Qilu Hospital, Shandong University, Jinan 250012, China

2 Department of Radiology, Liaocheng Traditional Chinese Medicine Hospital, Liaocheng 252000, China

3 Department of Pathology, Qilu Hospital, Shandong University, Jinan 250012, China

Corresponding author: YU D X, E-mail: yudexin0330@sina.com

Conflicts of interest   None.

Received  2025-04-07
Accepted  2025-05-09
DOI: 10.12015/issn.1674-8034.2025.05.006
Cite this article as: WANG F Q, CHEN Y H, SUN Y, et al. A preliminary study on quantitative parameter prediction of HIF-1α in pancreatic ductal adenocarcinoma using diffusion kurtosis imaging[J]. Chin J Magn Reson Imaging, 2025, 16(5): 37-43. DOI:10.12015/issn.1674-8034.2025.05.006.

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