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• Clinical Article •
Predictive value of pelvic lymph node metastasis in patients with cervical cancer based on IVIM-DWI parameters and texture features of its primary lesion
ZHANG Yu  QIAN Liting  DONG Jiangning  ZHENG Xiaomin  LI Cuiping  LIN Tingting  WEI Chao 

Cite this article as: Zhang Y, Qian LT, Dong JN, et al. Predictive value of pelvic lymph node metastasis in patients with cervical cancer based on IVIM-DWI parameters and texture features of its primary lesion[J]. Chin J Magn Reson Imaging, 2021, 12(8): 38-43. DOI:10.12015/issn.1674-8034.2021.08.008.


[Abstract] Objective To evaluate the clinical value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and texture analysis (TA) of primary lesions in preoperative prediction of pelvic lymph node metastasis (PLNM) in patients with cervical cancer. Materials andMethods A retrospective analysis was conducted that 101 cases of cervical carcinoma patients in Anhui Provincial Cancer Hospital confirmed by surgical pathology were divided into metastatic and non-metastatic groups according to the pathological results of lymph nodes. All patients underwent conventional MRI and IVIM-DWI scans before surgery. The IVIM-DWI parameters including difference of apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D*) and fractional of fast ADC (f) values were calculated by manually delineating tumor lesions on the axial IVIM-DWI images with a b value of 1200 s/mm2. The texture parameters were obtained by manually delineating tumor lesions layer by layer on the sagittal LAVA-FLEX delayed enhanced scans of uterus. All the ROIs were independently completed by two radiologists. The statistical analysis was conducted using independent two-sample t-test and Mann-Whitney U test to compare IVIM-DWI and TA parameters between two groups. Multivariate Logistic regression analysis and modeling were carried out for the parameters with statistically significant differences of univariate Logistic regression analysis, and the diagnostic efficiency of each parameter and model were evaluated by drawing the receiver operating characteristic (ROC) curve.Results Twenty-five patients were assigned into metastatic group and seventy-six patients in non-metastatic group. The f values of metastatic group were significantly higher than those of non-metastatic group (P=0.007), and its area under curve (AUC) was 0.681, while other IVIM-DWI parameters showed no statistical significances. Among the 828 texture parameters extracted, 4 parameters with high stability, independence and statistical significance were selected, including original first-order Mean, wavelet-LHH_glrlm Long Run High Gray-Level Emphasis (LRHGE), wavelet-HHH_glszm Zone Percentage (ZP) and wavelet-HHH_glcm Maximal Correlation Coefficient (MCC). The AUC of wavelet-HHH_glcm MCC was the largest of 0.769. Multivariate Logistic regression was used to analyze and model f values and the above 4 texture parameters, with the AUC of the prediction model was 0.919.Conclusions IVIM-DWI and TA have certain value in predicting PLNM of cervical carcinoma with the better predictive performance when using combined parameters.
[Keywords] intravoxel incoherent motion；diffusion weighted imaging；texture analysis；cervical cancer；pelvic lymph node metastasis

ZHANG Yu1   QIAN Liting1*   DONG Jiangning2*   ZHENG Xiaomin1   LI Cuiping2   LIN Tingting2   WEI Chao2  

1 Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China

2 Department of Radiology, West Branch of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, China

Qian LT, E-mail: money2006@163.com Dong JN, E-mail: dongjn@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS This work was part of Key Research and Development Projects of Anhui Province (No. 1804h08020294).
Received  2021-04-08
Accepted  2021-05-24
DOI: 10.12015/issn.1674-8034.2021.08.008
Cite this article as: Zhang Y, Qian LT, Dong JN, et al. Predictive value of pelvic lymph node metastasis in patients with cervical cancer based on IVIM-DWI parameters and texture features of its primary lesion[J]. Chin J Magn Reson Imaging, 2021, 12(8): 38-43. DOI:10.12015/issn.1674-8034.2021.08.008.

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