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. 2025 Apr 15:15:1565152.
doi: 10.3389/fonc.2025.1565152. eCollection 2025.

The value of multi-sequence magnetic resonance imaging and whole-tumor apparent diffusion coefficient histogram analysis in differentiating p53 abnormal from non-p53 abnormal endometrial carcinoma

Yuying Sun  1 , Jieying Zhang  1 , Yilin Wang  1 , Xinxin Zhang  1 , Yan Chen  1
Affiliations

The value of multi-sequence magnetic resonance imaging and whole-tumor apparent diffusion coefficient histogram analysis in differentiating p53 abnormal from non-p53 abnormal endometrial carcinoma

Yuying Sun et al. Front Oncol. .

Abstract

Objective: To investigate the utility of multi-sequence magnetic resonance imaging (MRI) and whole-tumor apparent diffusion coefficient (ADC) histogram metrics in preoperatively differentiating p53 abnormal (p53abn) from non-p53abn endometrial carcinoma (EC).

Methods: This retrospective study included 146 EC patients (29 p53abn cases and 117 non-p53abn cases) who underwent preoperative MRI scans. MRI features were analyzed. Whole-tumor ADC histogram analysis was conducted by delineating regions of interest (ROIs) on diffusion-weighted imaging (DWI) scans. Receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used for diagnostic performance evaluation.

Results: Extrauterine extension (p=0.004) and lymphadenopathy (p=0.005) were more frequently observed in p53abn EC compared to non-p53abn EC. p53abn EC exhibited significantly lower value of minADC (p=0.001), meanADC (p=0.005), P10 (p=0.009), P50 (p=0.007), and P90 (p=0.013) ADC and higher value of kurtosis (p=0.008), compared to non-p53abn EC. MinADC demonstrated the highest discrimination ability in differentiating p53abn from non-p53abn EC [AUC 0.70(0.60;0.80)].

Conclusion: Preoperative multi-sequence MRI findings and whole-tumor ADC histogram metrics are conducive to differentiating p53abn from non-p53abn EC.

Keywords: diffusion-weighted imaging; endometrial cancer; histogram analysis; magnetic resonance imaging; p53.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart illustrates the inclusion of study participants.
Figure 2
Figure 2
A 53-year-old woman with p53 abnormal endometrial cancer (endometrioid carcinoma, G3, stage IICmp53abn). The tumor shows slight hyperintensity on axial T2-weighted imaging (T2WI) (A), hyperintensity on axial diffusion-weighted imaging (DWI) (b=1000s/mm2) (B), and hypointensity on apparent diffusion coefficient (ADC) map (C). The region of interest (ROI) was drawn along the contour of tumor on DWI and subsequently transferred to the corresponding ADC maps through an automated process (yellow in B, C).
Figure 3
Figure 3
A 52-year-old woman with non-p53 abnormal endometrial cancer (endometrioid carcinoma, G2, stage IA2). The tumor shows slight hyperintensity on axial T2-weighted imaging (T2WI) (A), hyperintensity on axial diffusion-weighted imaging (DWI) (b=1000s/mm2) (B), and hypointensity on apparent diffusion coefficient (ADC) map (C). The region of interest (ROI) was drawn along the contour of tumor on DWI and subsequently transferred to the corresponding ADC maps through an automated process (yellow in B, C).
Figure 4
Figure 4
Receiver operating characteristic (ROC) curve of minADC to differentiate p53 abnormal from non-p53 abnormal endometrial cancer. The area under the curve (AUC) of minADC is 0.70(0.60;0.80).
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