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題名 Developing and validating a multivariable prediction model to improve the diagnostic accuracy in determination of cervical vs. endometrial origin of uterine adenocarcinomas
作者 Lin, G;Lin, YC;Wu, RC;Yang, LY;Lu, HY;Tsai, SY;Huang, YT;Huang, YL;Lu, KY;Ng, KK;Yen, TC;Chao, A;Lai, CH;Hong, JH
蔡尚岳
Tsai, Shang‐Yueh
貢獻者 應物所
關鍵詞 cervical carcinoma; diagnostic accuracy; diffusion-weighted imaging; endometrial carcinoma; magnetic resonance imaging; magnetic resonance spectroscopy
日期 2018-06
上傳時間 17-Dec-2018 15:14:38 (UTC+8)
摘要 BACKGROUND:A triage test to assist clinical decision-making on choosing primary chemoradiation for cervical carcinomas or primary surgery for endometrial carcinomas is important.PURPOSE OR HYPOTHESIS:To develop and validate a multiparametric prediction model based on MR imaging and spectroscopy in distinguishing adenocarcinomas of uterine cervical or endometrial origin.STUDY TYPE:Prospective diagnostic accuracy study.POPULATION:Eighty-seven women: 25 cervical and 62 endometrial adenocarcinomas divided into training (n = 43; cervical/endometrial adenocarcinomas = 11/32) and validation (n = 44; 14/30) datasets.FIELD STRENGTH/SEQUENCE:The 3T diffusion-weighted (DW) MR imaging and MR spectroscopy.ASSESSMENT:Morphology, volumetric DW MR imaging and spectroscopy (MDS) scoring system with total points 0-5, based on presence of the following MR features assessed independently by two radiologists: (a) epicenter at the cervix, (b) rim enhancement, (c) disrupted cervical stromal integrity, (d) mean volumetric apparent diffusion coefficient values (ADCmean) higher than 0.98 × 10-3 mm2 /s, (e) fatty acyl δ 1.3 ppm more than 161.92 mM. Histopathology as gold standard.STATISTICAL TESTS:Logistic regression and receiver operator characteristic (ROC) curves analysis.RESULTS:For both the training and validation datasets, the MDS score achieved an accuracy of 93.0% and 84.1%, significantly higher than that of morphology (88.4% and 79.5%), ADC value (74.4% and 68.2%), and spectroscopy (81.4% and 68.2%; P < 0.05 for all). The performances of the scoring were superior to the morphology in the training dataset (areas under the receiver operating characteristics curve [AUC] = 0.95 vs. 0.89; P = 0.046), but not in the validation dataset (AUC = 0.90 vs. 0.85; P = 0.289).DATA CONCLUSION:MDS score has potentials to improve distinguishing adenocarcinomas of cervical or endometrial origin, and warrants large-scale studies for further validation.
關聯 Journal of Magnetic Resonance Imaging, Vol.47, No.6, pp.1654-1666
資料類型 article
DOI http://dx.doi.org/10.1002/jmri.25899
dc.contributor 應物所
dc.creator (作者) Lin, G;Lin, YC;Wu, RC;Yang, LY;Lu, HY;Tsai, SY;Huang, YT;Huang, YL;Lu, KY;Ng, KK;Yen, TC;Chao, A;Lai, CH;Hong, JHen_US
dc.creator (作者) 蔡尚岳zh_TW
dc.creator (作者) Tsai, Shang‐Yuehen_US
dc.date (日期) 2018-06
dc.date.accessioned 17-Dec-2018 15:14:38 (UTC+8)-
dc.date.available 17-Dec-2018 15:14:38 (UTC+8)-
dc.date.issued (上傳時間) 17-Dec-2018 15:14:38 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/121403-
dc.description.abstract (摘要) BACKGROUND:A triage test to assist clinical decision-making on choosing primary chemoradiation for cervical carcinomas or primary surgery for endometrial carcinomas is important.PURPOSE OR HYPOTHESIS:To develop and validate a multiparametric prediction model based on MR imaging and spectroscopy in distinguishing adenocarcinomas of uterine cervical or endometrial origin.STUDY TYPE:Prospective diagnostic accuracy study.POPULATION:Eighty-seven women: 25 cervical and 62 endometrial adenocarcinomas divided into training (n = 43; cervical/endometrial adenocarcinomas = 11/32) and validation (n = 44; 14/30) datasets.FIELD STRENGTH/SEQUENCE:The 3T diffusion-weighted (DW) MR imaging and MR spectroscopy.ASSESSMENT:Morphology, volumetric DW MR imaging and spectroscopy (MDS) scoring system with total points 0-5, based on presence of the following MR features assessed independently by two radiologists: (a) epicenter at the cervix, (b) rim enhancement, (c) disrupted cervical stromal integrity, (d) mean volumetric apparent diffusion coefficient values (ADCmean) higher than 0.98 × 10-3 mm2 /s, (e) fatty acyl δ 1.3 ppm more than 161.92 mM. Histopathology as gold standard.STATISTICAL TESTS:Logistic regression and receiver operator characteristic (ROC) curves analysis.RESULTS:For both the training and validation datasets, the MDS score achieved an accuracy of 93.0% and 84.1%, significantly higher than that of morphology (88.4% and 79.5%), ADC value (74.4% and 68.2%), and spectroscopy (81.4% and 68.2%; P < 0.05 for all). The performances of the scoring were superior to the morphology in the training dataset (areas under the receiver operating characteristics curve [AUC] = 0.95 vs. 0.89; P = 0.046), but not in the validation dataset (AUC = 0.90 vs. 0.85; P = 0.289).DATA CONCLUSION:MDS score has potentials to improve distinguishing adenocarcinomas of cervical or endometrial origin, and warrants large-scale studies for further validation.en_US
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dc.relation (關聯) Journal of Magnetic Resonance Imaging, Vol.47, No.6, pp.1654-1666
dc.subject (關鍵詞) cervical carcinoma; diagnostic accuracy; diffusion-weighted imaging; endometrial carcinoma; magnetic resonance imaging; magnetic resonance spectroscopy
dc.title (題名) Developing and validating a multivariable prediction model to improve the diagnostic accuracy in determination of cervical vs. endometrial origin of uterine adenocarcinomasen_US
dc.type (資料類型) article
dc.identifier.doi (DOI) 10.1002/jmri.25899
dc.doi.uri (DOI) http://dx.doi.org/10.1002/jmri.25899