A Comparative Study Of Amide Proton Transfer Imaging And ¹⁸F-FDG PET/CT In The Evaluation Of The Grading Of Cervical Squamous Cell Carcinoma

Objective:To investigate the clinical value of the amide proton transfer?APT?imaging in the evaluation of the grading of squamous cell carcinoma of the cervix?SCCC?,and to compare it with ¹⁸F-FDG PET/CT.Material and Methods:Patients suspected of having SCCC were included in the study prospectively,and all patients without any intervention treatment.At least two weeks after endometrial exfoliation cytology examination,MRI-APT and ¹⁸F-FDG PET/CT examinations were performed.The APT signal intensity?APT SI?,maximum standard uptake value(SUV_max)and mean standard uptake value(SUV_mean)of lesions were measured and compared.According to the postoperative pathological results,they were divided into three grades:high differentiation?Grade 1?,medium differentiation?Grade2?and low differentiation?Grade 3?.Spearman correlation coefficient was used to analyze the correlation between the parameters and histological grading.One way analysis of variance and LSD post-test were used to compare the differences of parameters among the three histological grades.The diagnostic ability of each parameter was discussed by receiver operator characteristic curve?ROC?.The correlation between APT SI and SUVs was analyzed by Pearson correlation analysis.Results:Thirty-five patients were included in the study finally.According to the histopathological characteristics,the patients were classified as Grade 1?n=10?,Grade 2?n=13?and Grade 3?n=12?.There was a significant correlation between APT SI and SCCC histological grade,and the correlation coefficient was 0.716?P<0.001?.APT SI between different histological grades were significant differences?P<0.001,Grade 1 and Grade 3:P=0.017,Grade 1 and Grade 2:P<0.001,Grade 2 and Grade 3:P=0.002?,SUV_max and SUV_mean between Grade 1 and Grade 3 were significant differences?P=0.008,P=0.015,respectively?.There were no significant difference between Grade 1 and Grade2,Grade 2 and Grade 3 in SUV_max and SUV_mean(SUV_max:P=0.135,P=0.196;SUV_mean:P=0.133,P=0.303,respectively).The results of ROC analysis showed that the ability of APT SI in differential diagnosis of high and low differentiated SCCC was higher than that of SUV_max and SUV_mean.The correlation coefficients of APT SI and SUV_max,APT SI and SUV_mean were 0.084?P=0.633?and 0.126?P=0.470?,respectively.Conclusion:The APT SI is significantly correlated with the histological grade of SCCC,and APT imaging can be used as a potential prediction technique for the histological grade of SCCC.