Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI.
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Date
2017-02-01Author
Winfield, JM
Orton, MR
Collins, DJ
Ind, TEJ
Attygalle, A
Hazell, S
Morgan, VA
deSouza, NM
Type
Journal Article
Metadata
Show full item recordAbstract
OBJECTIVES: Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. METHODS: Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm-2). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. RESULTS: Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. CONCLUSIONS: Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. KEY POINTS: • Non-mono-exponential DW-MRI models are preferred in the majority of cervical tumours. • Poorly differentiated cervical tumours exhibit lower diffusion coefficients than well/moderately differentiated tumours. • Non-mono-exponential model parameters α, K, f, and D* differ between tumour types. • Micro-structural features are likely to affect parameters in non-mono-exponential models differently.
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Subject
Cervix Uteri
Humans
Adenocarcinoma
Carcinoma, Squamous Cell
Diffusion Magnetic Resonance Imaging
Bayes Theorem
Prospective Studies
Models, Theoretical
Uterine Cervical Neoplasms
Female
Male
Neoplasm Grading
Research team
Magnetic Resonance
Language
eng
Date accepted
2016-05-13
License start date
2017-02
Citation
European radiology, 2017, 27 (2), pp. 627 - 636
Publisher
SPRINGER