Objective:

To investigate the application of iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence (IDEAL-IQ) and intravoxel incoherent motion (IVIM) in assessing the proliferation status of endometrial carcinoma (EC).

Methods:

The data of 24 EC patients with low Ki-67 proliferation index (≤50%) and 19 EC patients with high Ki-67 proliferation index (＞50%) were retrospectively analyzed

and lesions’ fat fraction (FF) and R

2

* values of IDEAL-IQ and slow diffusion coefficient (ADC-slow)

fast diffusion coefficient (ADC-fast) and perfusion fraction (

f

) values of IVIM were measured and compared. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the diagnostic efficacy of each parameter

and logistic regression and DeLong tests were used for multiparameter combined diagnosis and analysis of variance between AUCs

respectively. The Spearman correlation was used to assess the correlation of each parameter value with Ki-67 proliferation index.

Results:

The ADC-slow

ADC-fast and R

2

* values were significantly lower in the high Ki-67 proliferation index group than in the low Ki-67 group (

P

were＜0.001

0.004

＜0.001

respectively). The AUCs for ADC-slow

ADC-fast

R

2

*

and the combination of the three to identify high and low Ki-67 proliferation index groups EC were 0.860

0.748

0.862

and 0.978

respectively

and DeLong analysis showed that the differences of AUC between ADC-slow+ADC-fast+R

2

* and ADC-slow

ADC-fast

and R

2

* were all statistically significant (

Z

=2.109

3.134

an

d 2.227;

P

=0.035

0.002

and 0.023

respectively). Both ADC-slow and R

2

* values were moderately negatively correlated with Ki-67 proliferation index (

r

=-0.547

-0.711

P

＜0.001) and ADC-fast was mildly negatively correlated with Ki-67 proliferation index levels (

r

=-0.324

P

=0.034).

Conclusion:

ADC-slow

ADC-fast

and R

2

* are all useful in assessing the proliferative status of cells in EC patients

and the combination of the three can able to discriminate more effectively between the Ki-67 proliferation index high and low groups of EC.