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Soft tissue sarcomas: IVIM and DKI correlate with the expression of HIF-1α on direct comparison of MRI and pathological slices

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate the correlation of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters with the expression of HIF-1α in soft tissue sarcoma (STS).

Methods

This prospective study was approved by the institutional ethics committee. Written informed consent was obtained from all patients. Forty patients with STS who underwent 3.0 T MRI, including IVIM and DKI, were included in the study. Standard apparent diffusion coefficient (ADC), true ADC (Dslow), pseudo ADC (Dfast), perfusion fraction (f), mean kurtosis (MK), and mean diffusivity (MD) of each lesion were independently analyzed by two observers. An MRI-pathology control method was used to ensure correspondence between the MRI slices and the pathological sections. Spearman analysis, independent sample t test, Mann-Whitney U test, chi-squared test, and receiver operating characteristic (ROC) curve analysis were performed.

Results

Dslow and MD values showed a negative correlation with HIF-1α expression (r = − 0.469, − 0.588). MK and f values showed a positive correlation with HIF-1α expression (r = 0.779, 0.572). Dslow, MD, MK, and f values showed significant differences between the high- and low-expression groups. The MK value showed the best diagnostic ability. The optimal cut-off MK value of 0.604 was associated with 78.3% sensitivity and 88.2% specificity (area under the curve, 0.867).

Conclusions

This preliminary study demonstrated the association of IVIM and DKI parameters with the expression of HIF-1α in STS.

Key Points

• IVIM and DKI parameters are correlated with the expression of HIF-1α in STS.

• The MRI-pathology control method can be used in clinical studies to ensure correspondence between MRI slices and pathology sections.

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Abbreviations

ADC:

Apparent diffusion coefficient

DKI:

Diffusion kurtosis imaging

DWI:

Diffusion-weighted imaging

EPI:

Echo-planar imaging

FNCLCC:

Fédération Nationale des Centres de Lutte Contre le Cancer

HIF:

Hypoxia-inducible factors

IVIM:

Intravoxel incoherent motion

ROI:

Region of interest

STS:

Soft tissue sarcoma

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Funding

This study has received funding from the National Natural Science Foundation of China (81771804).

Author information

Author notes

  1. Xiangwen Li and Lin Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning Province, China

    Xiangwen Li, Lin Yang & Shaowu Wang

  2. Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, China

    Qimeng Wang, Juan Tao & Ziang Pan

Authors
  1. Xiangwen Li
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  2. Lin Yang
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  3. Qimeng Wang
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  4. Juan Tao
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  5. Ziang Pan
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  6. Shaowu Wang
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Corresponding author

Correspondence to Shaowu Wang.

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Guarantor

The scientific guarantor of this publication is Shaowu Wang, MD, PHD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• case-control study/diagnostic study

• performed at one institution

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Li, X., Yang, L., Wang, Q. et al. Soft tissue sarcomas: IVIM and DKI correlate with the expression of HIF-1α on direct comparison of MRI and pathological slices. Eur Radiol 31, 4669–4679 (2021). https://doi.org/10.1007/s00330-020-07526-w

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  • DOI: https://doi.org/10.1007/s00330-020-07526-w

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