Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings

Abstract

Background Preoperative evaluation of aggressiveness, including tumor histological subtype, grade of differentiation, Federation International of Gynecology and Obstetrics (FIGO) stage, and depth of myometrial invasion, is significant for treatment planning and prognosis in endometrial carcinoma (EC). The purpose of this study was to evaluate whether three-dimensional (3D) magnetic resonance elastography (MRE) can help predict the aggressiveness of EC. Methods From August 2015 to January 2019, 82 consecutive patients with suspected uterine tumors underwent pelvic MRI and MRE scans, and 15 patients with confirmed EC after surgical resection were enrolled. According to pathological results (tumor grade, histological subtype, FIGO stage, and myometrial invasiveness), the patients were divided into two subgroups. The independent-samples t-test or Mann-Whitney U test was used to compare the stiffness between different groups. The diagnostic performance was determined with receiver operating characteristic (ROC) curve analysis. Results The stiffness of EC with ≥ 50 % (n = 6) myometrial invasion was significantly higher than that with < 50 % (n = 9) myometrial invasion (3.68 ± 0.59 kPa vs. 2.61 ± 0.72 kPa, p = 0.009). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 77.8 % specificity for differentiating ≥ 50 % myometrial invasion from < 50 % myometrial invasion of EC. The stiffness of poorly differentiated EC (n = 8) was significantly higher than that of well/moderately differentiated EC (n = 7) (3.47 ± 0.64 kPa vs. 2.55 ± 0.82 kPa, p = 0.028). Using a stiffness of 3.04 kPa as a cutoff value resulted in 75 % sensitivity and 71.4 % specificity for differentiating poorly differentiated from well/moderately differentiated EC. The stiffness of FIGO stage II/III EC was significantly higher than that of FIGO stage I EC (3.69 ± 0.65 kPa vs. 2.72 ± 0.76 kPa, p = 0.030). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 70 % specificity for differentiating FIGO stage I EC from FIGO stage II/III EC. The tumor stiffness value in type II (n = 3) EC was higher than that in type I (n = 12) EC (3.67 ± 0.59 kPa vs. 2.88 ± 0.85 kPa), but the difference was not significant (p = 0.136). Conclusions Tumor stiffness measured by 3D MRE may be potentially useful for predicting tumor grade, FIGO stage and myometrial invasion of EC and can aid in the preoperative risk stratification of EC.

Effect of 3D laparoscopy versus traditional laparotomy on serum tumor markers and coagulation function in patients with early-stage endometrial cancer

“…Factors contributing to these benefits include 3D laparoscopy's ability to offer surgeons a three-dimensional viewpoint, enhancing tissue structure differentiation and meticulous operation, Facilitating direct lesion site identification, allowing comprehensive cancerous tissue and metastatic lymphocyte removal, and Assisting precise adhesion differentiation between the lesion and adjacent tissues, preventing cancer cell proliferation and limiting damage to surrounding structures. 17 , 18 …”

In vitroandin vivoevidences propound therapeutic potential of Lipocalin 2 in cervical carcinoma

“…Recent reports have also suggested that matrix stiffness plays an important role in the prediction of aggressiveness and affects the morphology, drug sensitivity and mechanical properties of cervical cancer cells [69][70][71] . It can therefore be stated that treatment with anti-LCN2 antibody decreased the stiffness of the tumor, thus helping in tumor regression.…”

Evaluation of Spleen Stiffness in Young Healthy Volunteers Using Magnetic Resonance Elastography

“…Its ability to provide quantitative measurements of tissue properties opens up new possibilities for diagnosing and monitoring various pathologies and diseases. These potential applications of MRE are supported by evidence demonstrating excellent reproducibility and repeatability [30][31][32][33][34].…”