Application of amide proton transfer imaging combined with apparent diffusion coefficient in the differentiation of benign and malignant soft tissue tumors
Objective:To investigate the application value of amide proton transfer(APT)imaging combined with apparent diffusion coefficient(ADC)in the differential diagnosis of benign and malignant soft tissue tumors.Materials and Methods:Fifty-five patients with soft tissue tumors confirmed by pathology were retrospectively analyzed.There were 31 benign tumors and 24 malignant tumors.All patients underwent magnetic resonance APT and diffusion weighted imaging(DWI)examination before operation.Two observers measured the ADC value of DWI and the asymmetric magnetization transfer ratio of APT[MTRasym(3.5 ppm),and The APT value is abbreviated].The differences of ADC and APT values between benign and malignant tumors were compared.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of ADC,APT and their combination in differentiating benign and malignant soft tissue tumors.Results:The APT values of benign tumors were less than those of malignant tumors[1.90%+1.06%vs.3.29%+0.94%],the difference was statistically significant(t=-5.07,P<0.01).The ADC values of benign tumors were higher than those of malignant tumors[(1.70±0.54)×10-3 mm2/s vs.(1.15±0.56)×10-3 mm2/s],and the difference was statistically significant(t=3.68,P<0.01).The area under the curve(AUC),sensitivity and specificity of ADC,APT and their combination were 0.778[95%confidence interval(CI):0.646-0.879],62.5%,87.1%;0.838(95%CI:0.714-0.924),70.8%,90.3%;0.895(95%CI:0.783-0.962),83.3%,87.1%,respectively.There was no significant difference in AUC between ADC and APT(Z=0.664,P>0.05).The AUC of the combined diagnosis of the two was higher than that of ADC(Z=2.086,P<0.05),but there was no statistically significant difference in AUC with APT(Z=1.394,P>0.05)alone.Conclusions:Both APT and ADC can be used for the differential diagnosis of benign and malignant soft tissue tumors.The combination of APT and ADC can improve the diagnostic efficiency.