The value of amide proton transfer imaging in predicting parametrial invasion and lymph-vascular space invasion of cervical cancer

OBJECTIVE: To explore the value of amide proton transfer (APT) imaging in assessing parametrial invasion (PMI) and lymph-vascular space invasion (LVSI) of cervical cancer.

MATERIALS AND METHODS: We retrospectively analyzed the clinical and imaging data of cervical cancer patients diagnosed pathologically at our hospital from January 2021 to April 2024. All patients underwent routine magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and APT imaging before treatment. Apparent diffusion coefficient (ADC) and APT values were measured. Based on the pathological results, patients were categorized into LVSI (+) and LVSI (-) groups, and PMI (+) and PMI (-) groups. Independent sample t-tests were used to compare the ADC and APT values between these groups. Receiver operating characteristic (ROC) curves were used to assess the sensitivity, specificity, and area under the curve (AUC) of ADC, APT, and ADC + APT in predicting PMI and LVSI. The Delong test was employed to compare the diagnostic performance among these measures.

RESULTS: A total of 83 patients were included, with 56 in the LVSI (-) group, 27 in the LVSI (+) group, 35 in the PMI (-) group, and 16 in the PMI (+) group. The ADC values for the LVSI (+) and PMI (+) groups were significantly lower than those for the LVSI (-) and PMI (-) groups (P