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Soft tissue sarcoma: IVIM and DKI parameters correlate with Ki-67 labeling index on direct comparison of MRI and histopathological slices

  • Musculoskeletal
  • Published:
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Abstract

Objectives

To explore the correlation of parameters derived from intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) with Ki-67 labeling index (LI) in soft tissue sarcoma (STS).

Methods

Forty-one patients with STS underwent IVIM and DKI imaging at 3.0 MRI. The standard apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean diffusivity (MD) were compared between Ki-67 low- and high-expression groups by two independent observers. A novel method was used to ensure the topographic correlation of histologic sections and magnetic resonance imaging slices. Receiver operating characteristic (ROC), intraclass correlation coefficient (ICC), and Spearman’s rank correlations were performed for statistical analysis.

Results

The high-expression group displayed lower standard ADC, D, and MD values and a higher MK value than the low-expression group. No significant differences were found for D∗ and f values. The areas under the curve for standard ADC, D, MD, and MK when discriminating between low- and high-expression groups were 0.736, 0.745, 0.848, and 0.894, respectively. MK was positively correlated with Ki-67 LI (r = 0.809, p < 0.001). Standard ADC, D, and MD were negatively correlated with Ki-67 LI (r = −0.541, −0.556, −0.702, respectively, p < 0.001).

Conclusions

IVIM and DKI parameters are correlated with Ki-67 LI. MK may be the optimal imaging biomarker for assessing the Ki-67 expression of STS.

Key Points

• IVIM and DKI parameters are correlated with the expression of Ki-67 in STS.

• The MRI-pathology control method ensured a strong correlation between MRI slices and histologic sections, resulting in a robust radiological-pathological correlation.

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Abbreviations

ADC:

Apparent diffusion coefficient

DKI:

Diffusion kurtosis imaging

DWI:

Diffusion-weighted imaging

ICC:

Intraclass correlation coefficient

IVIM:

Intravoxel incoherent motion

LI:

Labeling index

MRI:

Magnetic resonance imaging

ROC:

Receiver operating characteristic

STS:

Soft tissue sarcoma

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Funding

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

Author information

Author notes

  1. Kai Zhang and Yue Dai contributed equally to this work.

Authors and Affiliations

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

    Kai Zhang, Yajie Liu & Shaowu Wang

  2. Department of Radiology, Dalian Municipal Central Hospital, Dalian, China

    Yue Dai

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

    Juan Tao & Ziang Pan

  4. GE Healthcare, MR Research China, Beijing, China

    Lizhi Xie

Authors
  1. Kai Zhang
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  2. Yue Dai
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  3. Yajie Liu
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  4. Juan Tao
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  5. Ziang Pan
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  6. Lizhi Xie
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  7. Shaowu Wang
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Corresponding author

Correspondence to Shaowu Wang.

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Ethical approval

The study was approved by the Institutional Ethics Committee of the second Hospital of Dalian Medical University.

Informed consent

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

Conflict of interest

One of the authors (Lizhi Xie) is an employee of GE Healthcare. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Guarantor

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

Statistics and biometry

One of the authors has significant statistical expertise.

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• prospective

• case-control study/diagnostic study

• performed at one institution

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Zhang, K., Dai, Y., Liu, Y. et al. Soft tissue sarcoma: IVIM and DKI parameters correlate with Ki-67 labeling index on direct comparison of MRI and histopathological slices. Eur Radiol 32, 5659–5668 (2022). https://doi.org/10.1007/s00330-022-08646-1

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  • DOI: https://doi.org/10.1007/s00330-022-08646-1

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