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Can magnetic resonance spectroscopy differentiate endometrial cancer?

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate whether the choline-containing compounds (Cho) obtained from three-dimensional 1H magnetic resonance (MR) spectroscopy can differentiate endometrial cancer (ECa) from benign lesions in endometria or in submucosa (BLs-ESm) and is associated with the aggressiveness of ECa.

Methods

Fifty-seven patients (ECa, 38; BLs-ESm, 19) underwent preoperative multi-voxel MR spectroscopy at 3.0 T. The ratio of the sum of the Cho peak integral to the sum of the unsuppressed water peak integral (Cho/water) and the coefficient of variation (CV) used to describe the variability of Cho/water in one lesion were calculated.

Results

Mean Cho/water (±standard deviation [SD]) was (3.02 ± 1.43) × 10−3 for ECa and (1.68 ± 0.33) × 10−3 for BLs-ESm (p < 0.001). Mean Cho/water was (4.42 ± 1.53) × 10−3 for type II ECa and (2.65 ± 1.17) × 10−3 for type I ECa (p = 0.001). There were no significant differences among different stages of ECa (p = 0.107) or different grades of ECa (p = 0.142). The Cho/water was positively correlated with tumour stage (r = 0.386, p = 0.017) and size (r = 0.333, p = 0.041). The CV was also positively correlated with tumour stage (r = 0.537, p = 0.001) and size (r = 0.34, p = 0.037).

Conclusion

The Cho/water can differentiate ECa from BLs-ESm and differentiate type II from type I ECa, but cannot differentiate different stages of ECa or different grades of ECa. Cho/water increased with the increase of tumour stage and size.

Key Points

• First report to attempt to assess ECa aggressiveness with magnetic resonance spectroscopy (MRS).

• MRS can differentiate type I from type II ECa.

• MRS can differentiate ECa from BLs-ESm.

• MRS cannot differentiate different stages of ECa or different grades of ECa.

• Cho/water increased with the increase of tumour stage and size.

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Abbreviations

AUC:

area under the ROC curve

BLs-ESm:

benign lesions in endometria or in submucosa

Cho:

choline-containing compounds

CRSD:

Cramér-Rao standard deviation

CV:

coefficient of variation

D & C:

dilatation and curettage

DCE:

dynamic contrast-enhanced

DWI:

diffusion-weighted imaging

ECa:

endometrial cancer

MRS:

magnetic resonance spectroscopy

ROC:

receiver operating characteristic

T2W:

T2-weighted

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Acknowledgments

The scientific guarantor of this publication is Qingwei Liu. The authors of this manuscript declare relationships with the following companies: Siemens Shenzhen Magnetic Resonance Ltd. This study has received funding by Shandong Province Science and Technology Development Plan (grants no. 2012GSF11820 and no. 2012YD18053). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. The study subjects or cohorts have not been previously reported. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Shandong Provincial Hospital, Shandong University, 324# Jingwu Weiqi road, Jinan, People’s Republic of China

    Jie Zhang, Shifeng Cai, Xue Han, Qingwei Liu & Yinghui Xin

  2. Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, 324# Jingwu Weiqi road, Jinan, People’s Republic of China

    Changzhong Li & Chunrun Yang

  3. Department of Pathology, Shandong Provincial Hospital, Shandong University, 324# Jingwu Weiqi road, Jinan, People’s Republic of China

    Xichao Sun & Yuanyuan Zong

  4. Siemens Shenzhen Magnetic Resonance Ltd., Siemens MRI Center, Gaoxin C. AVE., 2nd, Hi-Tech Industrial Park, Shenzhen, People’s Republic of China

    Caixia Fu

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  1. Jie Zhang
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Correspondence to Qingwei Liu.

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Zhang, J., Cai, S., Li, C. et al. Can magnetic resonance spectroscopy differentiate endometrial cancer?. Eur Radiol 24, 2552–2560 (2014). https://doi.org/10.1007/s00330-014-3237-3

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  • DOI: https://doi.org/10.1007/s00330-014-3237-3

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