Association of the Liver and Spleen Signal Intensity on MRI with Anemia in Gynecological Cancer.

Abstract

This study investigates the association of the liver and spleen signal intensity on MRI with anemia in patients with gynecologic cancer. 332 patients with gynecological cancer and 78 healthy women underwent MRI examination. Liver and spleen MRI parameters and laboratory tests were obtained within 1 week. The signal intensity ratios of liver and spleen to the paraspinal muscle were calculated on gradient-echo T1-weighted images (T1WI) and T2-weighted images (T2WI) in both patients and healthy women, respectively. The ratios of liver and spleen to paraspinal muscle on T1WI and T2WI were lower in patients than in the healthy women, respectively (P<0.0001). The ratios of the liver and spleen to paraspinal muscle on T1WI and T2WI decreased with the increasing stage of anemia and decreasing hemoglobin levels (P<0.001). The ratios of the liver to paraspinal muscle on T1WI, spleen to paraspinal muscle on T1WI, and the liver and spleen to paraspinal muscle on T2WI could predict anemia stage≥1 (AUC=0.576, 0.643, 0.688, and 0.756, respectively), ≥2 (AUC=0.743, 0.714, 0.891, and 0.922, respectively) and 3 (AUC=0.851, 0.822, 0.854, and 0.949, respectively). T2WI-based spleen signal intensity ratios showed the highest potential for non-invasive evaluation of anemia in gynecological cancer.