Magnetic resonance spectroscopy associations with clinicopathologic features of estrogen-dependent endometrial cancer

Background We studied the magnetic resonance spectroscopy (MRS) associations with clinicopathologic features of estrogen-dependent endometrial cancer (type I EC). Methods Totally 45 patients with type I EC who underwent preoperative multi-voxel MRS at 3.0 T were enrolled. The mean ratio of the Cho peak integral to the unsuppressed water peak integral (Cho/water) of the tumor was calculated. The Cho/water and apparent diffusion coefficient (ADC) of type I EC with and without local invasion, as well as with different levels of Ki-67 staining index (SI) ([less than or equai to] 40% and > 40%), were compared. Correlation test was used to examine the relationship of Cho/water, as well as mean ADC, with Ki-67 SI, tumor stage, and tumor grade. Results The mean Cho/water of EC with Ki-67 SI [less than or equai to] 40% (2.28 [+ or -] 0.93) x 10.sup.-3 was lower than that with Ki-67 SI > 40% (4.08 [+ or -] 1.00) x 10.sup.-3 (P < 0.001). The mean Cho/water of EC with deep and superficial myometrial invasion was (3.41 [+ or -] 1.26) x 10.sup.-3 and (2.43 [+ or -] 1.11) x 10.sup.-3, respectively (P = 0.011). There was no significant difference in Cho/water between type I EC with and without cervical invasioin ([2.68 [+ or -] 1.00] x 10.sup.-3 and [2.77 [+ or -] 1.28] x 10.sup.-3, P = 0.866). The mean Cho/water of type I EC with and without lymph node metastasis was (4.02 [+ or -] 1.90) x 10.sup.-3 and (2.60 [+ or -] 1.06) x 10.sup.-3, respectively (P = 0.014). The Cho/water was positively correlated with the Ki-67 SI (r = 0.701, P < 0.001). There were no significant differences in ADC among groups (all P > 0.05). Conclusion MRS is helpful for preoperative assessment of clinicopathological features of type I EC. Keywords: Type I endometrial cancer, Ki-67, Local invasiveness, Magnetic resonance spectroscopy