Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method

ObjectiveTo investigate an in vivo biopsy method based on CT-MRI fusion image registration and evaluate its value for improving the accuracy of preoperative core needle biopsies(CNBs) histological grading in soft tissue sarcoma (STS)and determining the correlation between multiparametric MRI(mp MRI)...

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Main Authors: Nan Xu, Yang Lu, Xingrong Yang, Juan Tao, Lei Shi, Chuanshu Sun, Shaowu Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1606942/full
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author Nan Xu
Yang Lu
Xingrong Yang
Juan Tao
Lei Shi
Chuanshu Sun
Shaowu Wang
author_facet Nan Xu
Yang Lu
Xingrong Yang
Juan Tao
Lei Shi
Chuanshu Sun
Shaowu Wang
author_sort Nan Xu
collection DOAJ
description ObjectiveTo investigate an in vivo biopsy method based on CT-MRI fusion image registration and evaluate its value for improving the accuracy of preoperative core needle biopsies(CNBs) histological grading in soft tissue sarcoma (STS)and determining the correlation between multiparametric MRI(mp MRI) and both STS French Federation of Cancer Center (FNCLCC) grading and the Ki-67 labeling index (LI).Methods32 STS patients were enrolled prospectively and underwent 3.0T MRI, Diffusion weighted imaging(DWI) and Hydrogen proton magnetic resonance spectroscopy (1H MRS) examination, then underwent a preoperative CT guided CNBs that was confirmed by subsequent surgery. We used a novel image fusion registration method to ensure the biopsy sampling point was located in a high cell density area and the MRI-Region of Interest (ROI) was compatible with the biopsy specimen. We evaluated the accuracy of biopsy pathology diagnoses compared to that of surgery, and compared the mp MRI parameters between FNCLCC low- and high-grade/Ki67 low- and high-expression groups. The statistical analyses included the intraclass correlation coefficient(ICC), the Wilcoxon rank-sum test, Receiver Operating Characteristic (ROC) curves, and Spearman’s rank correlation.ResultThe pathological diagnosis accuracy of the biopsy specimens was 100%, the subtype diagnosis accuracy was 87.5%, while the grading diagnosis accuracy was 93.8% compared with that of the surgical specimens. The FNCLCC high-grade group and Ki67 high-expression group had lower Apparent diffusion coefficient(ADC) values and higher Cholin/Creatin (Cho/Cr) ratios. The area under the curve(AUC) of ADCmin, ADCmean values and Cho/Cr ratios to discriminate between low- and high-grade groups were 0.956,0.969,0.917, low and high expression groups were 0.929,0.957,0.943; The ADC values of STSs correlated negatively while the Cho/Cr ratios correlated positively with FNCLCC grading (r=-0.782,-0.814, 0.758,p<0.001) and Ki-67 LI (r=-0.853, -0.902,0.710,p<0.001).ConclusionThe CT-MRI fusion image registration method may improve the accuracy of pre treatment STS CNBs pathology diagnoses and can be used for precise imaging-pathology control studies. ADC values and Cho/Cr ratios may therefore serve as a valuable supplement to STS histopathological grading and correlate with Ki67 expression.
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spelling doaj-art-359dabda172143d7828bd387c73ddbbd2025-08-20T03:38:54ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16069421606942Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration methodNan Xu0Yang Lu1Xingrong Yang2Juan Tao3Lei Shi4Chuanshu Sun5Shaowu Wang6Department of Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Pathology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Pathology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Radiology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, ChinaDepartment of Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaDepartment of Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, ChinaObjectiveTo investigate an in vivo biopsy method based on CT-MRI fusion image registration and evaluate its value for improving the accuracy of preoperative core needle biopsies(CNBs) histological grading in soft tissue sarcoma (STS)and determining the correlation between multiparametric MRI(mp MRI) and both STS French Federation of Cancer Center (FNCLCC) grading and the Ki-67 labeling index (LI).Methods32 STS patients were enrolled prospectively and underwent 3.0T MRI, Diffusion weighted imaging(DWI) and Hydrogen proton magnetic resonance spectroscopy (1H MRS) examination, then underwent a preoperative CT guided CNBs that was confirmed by subsequent surgery. We used a novel image fusion registration method to ensure the biopsy sampling point was located in a high cell density area and the MRI-Region of Interest (ROI) was compatible with the biopsy specimen. We evaluated the accuracy of biopsy pathology diagnoses compared to that of surgery, and compared the mp MRI parameters between FNCLCC low- and high-grade/Ki67 low- and high-expression groups. The statistical analyses included the intraclass correlation coefficient(ICC), the Wilcoxon rank-sum test, Receiver Operating Characteristic (ROC) curves, and Spearman’s rank correlation.ResultThe pathological diagnosis accuracy of the biopsy specimens was 100%, the subtype diagnosis accuracy was 87.5%, while the grading diagnosis accuracy was 93.8% compared with that of the surgical specimens. The FNCLCC high-grade group and Ki67 high-expression group had lower Apparent diffusion coefficient(ADC) values and higher Cholin/Creatin (Cho/Cr) ratios. The area under the curve(AUC) of ADCmin, ADCmean values and Cho/Cr ratios to discriminate between low- and high-grade groups were 0.956,0.969,0.917, low and high expression groups were 0.929,0.957,0.943; The ADC values of STSs correlated negatively while the Cho/Cr ratios correlated positively with FNCLCC grading (r=-0.782,-0.814, 0.758,p<0.001) and Ki-67 LI (r=-0.853, -0.902,0.710,p<0.001).ConclusionThe CT-MRI fusion image registration method may improve the accuracy of pre treatment STS CNBs pathology diagnoses and can be used for precise imaging-pathology control studies. ADC values and Cho/Cr ratios may therefore serve as a valuable supplement to STS histopathological grading and correlate with Ki67 expression.https://www.frontiersin.org/articles/10.3389/fonc.2025.1606942/fullCT-MRI fusion registrationprecise imaging-pathology controlmp MRISTSCT-guided percutaneous CNBsFNCLCC grading
spellingShingle Nan Xu
Yang Lu
Xingrong Yang
Juan Tao
Lei Shi
Chuanshu Sun
Shaowu Wang
Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
Frontiers in Oncology
CT-MRI fusion registration
precise imaging-pathology control
mp MRI
STS
CT-guided percutaneous CNBs
FNCLCC grading
title Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
title_full Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
title_fullStr Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
title_full_unstemmed Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
title_short Research on application of multiparametric MRI to predict FNCLCC grading and ki67 expression in soft tissue sarcoma biopsy pathology: Based on a CT-MRI fusion image registration method
title_sort research on application of multiparametric mri to predict fnclcc grading and ki67 expression in soft tissue sarcoma biopsy pathology based on a ct mri fusion image registration method
topic CT-MRI fusion registration
precise imaging-pathology control
mp MRI
STS
CT-guided percutaneous CNBs
FNCLCC grading
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1606942/full
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