The value of automatic extraction of quantitative magnetic susceptibility signal within tumors combined with R2* value in evaluating the FIGO staging of ovarian cancer
Objective:To investigate the predictive value of R2* values of enhanced T2* weighted angiography(ESWAN) sequence and automatic extraction of quantitative intratumor magnetic sensitive signal (ITSS) in the clinical staging of ovarian cancer patients in the international federation of obstetrics and gynecology (FIGO). Materials and Methods:The data of 37 patients with pathologically confirmed ovarian cancer who underwent 1.5T MRI scan (including ESWAN sequence) were retro-spectively analyzed. Among them,7 cases involved bilateral ovaries,with a total of 44 ovarian lesions. According to FIOG stage,they were divided into early group (FIGO stage Ⅰ to Ⅱ),18 patients with 19 ovarian lesions,and late group (FIGO stage Ⅲ to Ⅳ),19 patients with 25 ovarian lesions. The R2* values of lesions in the two groups were measured by 2 ob-servers,and AnatomySketh software was used to delineate lesions,and quantitative ITSS lesion maximum slice ratio(ITSSs) and ITSS lesion tumor volume ratio(ITSSv) were obtained. Intra-group correlation coefficient(ICC) was used to evaluate the consis-tency of the measurements between observers. The difference of parameters between the two groups was compared,and the threshold values and diagnostic efficacy of R2* and ITSS parameters were evaluated by receiver operating characteristic(ROC) curve. Logistic regression analysis was used to combine the three groups of parameters and evaluate their diagnostic efficacy. Delong test was used to compare the difference in area under ROC curve (AUC). Results:The parameters of the two groups were consistent (ICC>0.75),and the R2* value,ITSSs and ITSSv of the advanced ovarian cancer group were 16.97 (12.44,22.41) Hz,0.24(0.19,0.27),0.23(0.20,0.27),respectively,which were higher than those of early ovarian cancer group at 10.66 (9.01,12.82) Hz,0.14(0.10,0.21),0.17(0.11,0.21),and the differences were statistically significant(Z=-3.732,-2.926,-2.974,all P<0.05). The AUC values of R2*,ITSSs,ITSSv and their combination were 0.832,0.760,0.764 and 0.897,respectively. The AUC value of their combination was the highest,and the sensitivity and specificity of the diagnosis of advanced ovarian cancer were 92.0％ and 68.4％,respectively. Compared with ITSSs and ITSSv,there was no significant difference in diagnostic efficiency of R2*(Z=0.671,0.664,P=0.502,0.506). The diagnostic efficacy of the combination of the three was better than that of ITSSs,and the difference was statistically significant (Z=1.977,P=0.048),while the diagnostic efficacy of the combination of the three was not statistically significant compared with R2* and ITSSv (Z=1.366,1.807,P=0.171,0.07). Conclusion:Both R2* value and ITSS can effectively predict the FIGO stage of ovarian cancer,automatic extraction of quantitative ITSS is more convenient,and the combined diagnosis of the three can effectively improve the diagnostic efficiency.
万方数据
维普
