Whole-Lesion Apparent Diffusion Coefficient-Based Entropy-Related Parameters for Characterizing Cervical Cancers: Initial Findings.
This study aimed to develop whole-lesion apparent diffusion coefficient (ADC)-based entropy-related parameters of cervical cancer to preliminarily assess intratumoral heterogeneity of this lesion in comparison to adjacent normal cervical tissues.



A total of 51 women (mean age, 49 years) with cervical cancers confirmed by biopsy underwent 3-T pelvic diffusion-weighted magnetic resonance imaging with b values of 0 and 800 s/mm2prospectively. ADC-based entropy-related parameters including first-order entropy and second-order entropies were derived from the whole tumor volume as well as adjacent normal cervical tissues. Intraclass correlation coefficient, Wilcoxon test with Bonferroni correction, Kruskal-Wallis test, and receiver operating characteristic curve were used for statistical analysis.



All the parameters showed excellent interobserver agreement (all intraclass correlation coefficients  > 0.900). Entropy, entropy(H)0, entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)meanwere significantly higher, whereas entropy(H)rangeand entropy(H)stdwere significantly lower in cervical cancers compared to adjacent normal cervical tissues (all P <.0001). Kruskal-Wallis test showed that there were no significant differences among the values of various second-order entropies including entropy(H)0,entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)mean.All second-order entropies had larger area under the receiver operating characteristic curve than first-order entropy in differentiating cervical cancers from adjacent normal cervical tissues. Further, entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)meanhad the same largest area under the receiver operating characteristic curve of 0.867.



Whole-lesion ADC-based entropy-related parameters of cervical cancers were developed successfully, which showed initial potential in characterizing intratumoral heterogeneity in comparison to adjacent normal cervical tissues.
School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Road, Nanjing 210046, China.
Yue
Y
Guan
School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Road, Nanjing 210046, China.
Weifeng
W
Li
School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Road, Nanjing 210046, China.
Zhuoran
Z
Jiang
School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Road, Nanjing 210046, China.
Ying
Y
Chen
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing 210008, China.
Song
S
Liu
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing 210008, China. Electronic address: hjxueren@163.com.
Jian
J
He
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing 210008, China. Electronic address: zyzhou@nju.edu.cn.
Zhengyang
Z
Zhou
School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Road, Nanjing 210046, China. Electronic address: geyunnju@126.com.
Yun
Y
Ge
D000328:Adult; D000368:Aged; D001706:Biopsy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D019277:Entropy; D005260:Female; D006801:Humans; D008875:Middle Aged; D012372:ROC Curve; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
Diffusion-weighted magnetic resonance imaging; apparent diffusion coefficient; entropy; texture analysis; uterine cervical neoplasms