Amide proton transfer-weighted imaging combined with multiple models diffusion-weighted imaging of endometrial cancer - correlations between multimodal MRI parameters and HIF-1a expression

Sep 15, 2026

This retrospective study evaluated how multimodal MRI metrics relate to HIF-1a expression in endometrial cancer and whether such imaging can quantitatively assess HIF-1a. Ninety-four patients were screened, with 32 included in the high-expression group and 40 in the low-expression group. APTw, conventional DWI, IVIM, and DKI were used to derive MTRasym, ADC, D, D*, f, MK, and MD, which were compared between groups and tested with correlation and ROC-based performance analyses. Results showed significant group differences and identification of f, MK, and MD as independent predictors, with multimodal combinations improving evaluation efficiency.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages14

Reading Time35 min

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Background

Purpose

Methods

Population and design

MRI parameters and assessment

Results

Conclusion

TYPE Original Research PUBLISHED 28 April 2025 DOI 10.3389/fonc.2025.1556311 OPEN ACCESS EDITED BY Silvia Capuani, National Research Council (CNR), Italy REVIEWED BY Zhenyu Shu, Zhejiang Provincial People’s Hospital, China Violante Di Donato, Unitelma Sapienza University, Italy *CORRESPONDENCE Ailian Liu [liuailian@dmu.edu.cn](liuailian@dmu.edu.cn) RECEIVED 06 January 2025 ACCEPTED 31 March 2025 PUBLISHED 28 April 2025 CORRECTED 26 September 2025 CITATION Li J, Ma C, Tian S, Liu A, Song Q, Wang N, Song Q, Lin L, Sun P and Wang J (2025) Amide proton transfer-weighted imaging combined with multiple models diffusionweighted imaging of endometrial cancer: correlations between multi-modal MRI parameters and HIF-1a expression. Front. Oncol. 15:1556311 . doi: 10.3389/fonc.2025.1556311 COPYRIGHT © 2025 Li, Ma, Tian, Liu, Song, Wang, Song, Lin, Sun and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Amide proton transfer-weighted imaging combined with multiple models diffusion-weighted imaging of endometrial cancer: correlations between multimodal MRI parameters and HIF-1a expression Jun Li 1, Changjun Ma 2, Shifeng Tian 1,3, Ailian Liu 1,3,4*, Qingling Song 1,3, Nan Wang1,3, Qingwei Song 1,3, Liangjie Lin 5, Peng Sun 5 and Jiazheng Wang 5 1 Department of Radiology, The First Afﬁliated Hospital of Dalian Medical University, Dalian, Liaoning, China, 2School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, Dalian, Liaoning, China, 3 Dalian Medical Image Artiﬁcial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China, 4Technology Innovation Center of Hyperpolarized MRI, Dalian, Liaoning, China, 5 Philips Health Technology (China) Co., Ltd., Beijing, China Background: Hypoxia inducible factor (HIF-1a) is a major transcriptional factor regulating gene expression under hypoxic conditions. HIF-1a expression was closely correlated with the oxygenation status of tumor and could serve as an important biomarker for tumor hypoxia, aggressiveness, or radiation resistance. High expression of HIF-1a contributes to high aggressiveness or poor prognosis of endometrial cancer. Purpose: This study aimed to investigate correlations between multimodal MRI parameters (derived from amide proton transfer weighted imaging [APTw], conventional diffusion weighted imaging [DWI], intravoxel incoherent motion [IVIM] imaging and diffusion kurtosis imaging [DKI]) and HIF-1a expression, and to determine whether multimodal MRI can be used for quantitative evaluation of HIF-1a expression. Study type: Retrospective. Population: A total of 94 patients with EC were examined with 32 cases ﬁnally included in the high HIF-1a expression group and 40 cases included in the low expression group according to the exclusion and inclusion criteria. Field Strength/Sequence: 3. 0T/APTw, DWI, IVIM, and DKI Assessment: The asymmetry of magnetization transfer rate (MTRasym), apparent diffusion coefﬁcient (ADC), pure diffusion coefﬁcient (D), pseudo diffusion coefﬁcient (D*), perfusion fraction (f), mean kurtosis (MK), and mean diffusivity (MD) were calculated from multimodal MRI and compared between HIF-1a high expression and HIF-1a low expression groups. Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) Statistical Test: Mann–Whitney U-test; Chi-square test or Fisher exact test; logistic regression analysis; Area under the receiver operating characteristic (ROC) curve (AUC); The Delong test; Pearson or Spearman correlation coefﬁcients. The signiﬁcance th

FAQs

What imaging modalities and parameters were used to study HIF-1a expression?

The study used amide proton transfer-weighted imaging (APTw) plus conventional DWI, IVIM, and DKI. Derived parameters included MTRasym, ADC, D, D*, f, MK, and MD.

How were patients grouped for comparison of HIF-1a expression?

Patients with endometrial cancer were classified into high HIF-1a expression and low HIF-1a expression groups based on exclusion and inclusion criteria, resulting in 32 and 40 patients respectively.

Which MRI parameters independently predicted HIF-1a expression?

Multivariate analysis identified f, MK, and MD as independent predictors for evaluating HIF-1a expression in endometrial cancer.

Sep 15, 2026

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