Amide proton transfer imaging to evaluate the grading of squamous cell carcinoma of the cervix: A comparative study using 18F FDG PET

Background

Amide proton transfer (APT) imaging has shown great potential value in the diagnosis of cancer, but has yet not been applied in cervical carcinoma patients.

Purpose

To investigate the utility of APT imaging in estimating histologic grades of squamous cell carcinoma of the cervix (SCCC), compared with the standardized uptake value (SUV).

Study Type

Prospective.

Population

Thirty‐one patients with SCCC (median age 51 years) were included.

Field Strength/Sequence

Ingenia 3.0 T CX, Axial T₁‐weighted imaging (T₁WI), Axial T₂WI, 3D turbo spin echo sequence for APT imaging.

Assessment

Patient pathology was confirmed by surgery and the patients were divided into three groups based on histologic grades: Grade 1 (n = 9), Grade 2 (n = 12), and Grade 3 (n = 10). The APT signal intensity (APT SI), maximum SUV (SUV_max) and mean SUV (SUV_mean) for each grade were assessed by experienced radiologists in a blinded manner.

Statistical Tests

The obtained parameters were compared by one‐way analysis of variance with Tukey honest significant difference post‐hoc test. The correlations between the parameters and histologic grades were analyzed by Spearman's correlation coefficient. The Pearson correlation coefficients of the APT SI with the SUV_max and SUV_mean were also calculated.

Results

The APT SIs for the three grades were significantly different (P = 0.0002). The APT SIs of Grade 2 and Grade 3 had significant differences (P = 0.009). The Spearman correlation coefficients for the correlations between the parameters and histological grade were as follows: APT SI: 0.684 (P = 0.00002), SUV_max: 0.318 (P = 0.082), and SUV_mean: 0.261 (P = 0.157). The Pearson correlation coefficients of the APT SI with the SUV_max and SUV_mean were 0.108 (P = 0.564) and 0.178 (P = 0.337), respectively.

Data Conclusion

The APT SI was positively correlated with the SCCC grades. APT imaging maybe a promising method for predicting SCCC histologic grades.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018.

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