scholarly journals The added value of diffusion-weighted imaging in the preoperative assessment of endometrial cancer

2019 ◽  
Vol 52 (4) ◽  
pp. 229-236
Author(s):  
Rui Tiago Gil ◽  
Teresa Margarida Cunha ◽  
Mariana Horta ◽  
Ines Alves
Keyword(s):  
Endometrial Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diffusion Weighted Imaging ◽  
Myometrial Invasion ◽  
Preoperative Assessment ◽  
Added Value ◽  
P Value ◽  
Dce Mri ◽  
Diffusion Weighted

Abstract Objective: To evaluate the added value of diffusion-weighted imaging (DWI) in the preoperative assessment of myometrial invasion in endometrial cancer, in comparison with T2-weighted imaging (T2WI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Materials and Methods: This was a retrospective study involving 44 women with endometrial cancer who underwent preoperative 1.5 T MRI. Two radiologists, both of whom were blinded to the histopathology reports, performed a consensus interpretation of the depth of myometrial invasion and of the stage of the cancer, considering three sets of sequences: T2WI, DCE-MRI+T2WI, and DWI+T2WI. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each set. The accuracy was compared with p-value adjustment by the Benjamini-Hochberg procedure. Results: Among the 44 patients evaluated, DWI+T2WI demonstrated better diagnostic performance in assessing deep myometrial invasion and correctly staged more patients (n = 41) than did DCE-MRI+T2WI (n = 34) and T2WI (n = 22). The superior diagnostic accuracy of DWI+T2WI was statistically significant in comparison with T2WI (p < 0.05) but not in comparison with DCE-MRI+T2WI (p > 0.05). Conclusion: The addition of DWI apparently improves the diagnostic accuracy of MRI in the preoperative assessment of the depth of myometrial invasion in endometrial cancer, which may be particularly helpful in patients for whom contrast agents are contraindicated.

Diagnostic Accuracy of Magnetic Resonance Imaging in Endometrial Cancer

2012 ◽  
Vol 22 (6) ◽  
pp. 1020-1025 ◽  
Author(s):  
Mark H. McComiskey ◽  
W. Glenn McCluggage ◽  
Arthur Grey ◽  
Ian Harley ◽  
Stephen Dobbs ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Endometrial Cancer ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Myometrial Invasion ◽  
Preoperative Assessment ◽  
Tumor Board ◽  
Resonance Imaging ◽  
Outer Half

ObjectivesThe objectives of this study were to investigate the accuracy of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion in the preoperative assessment of women with endometrial cancer and to quantify the impact of MRI as an adjunct to predicting patients requiring full surgical staging.MethodsThis was a diagnostic accuracy study of prospective cases in conjunction with STARD guidelines using collected data from a tumor board within a cancer network. Consecutive series of all endometrial cancers in Northern Ireland over a 21-month period was discussed at the Gynaecological Oncology Multidisciplinary Team/tumor board meeting. This study concerns 183 women who met all the inclusion criteria. Main outcome measure was the correlation between the depth of myometrial invasion suggested by preoperative MRI study and the subsequent histopathological findings following examination of the hysterectomy specimen. Secondary end point was how MRI changed management of women who required surgery to be performed at a central cancer center.ResultsFor the detection of outer-half myometrial invasion, overall sensitivity of MRI was 0.73 (95% confidence interval [CI], 0.59–0.83), and specificity was 0.83 (95% CI, 0.76–0.89). The positive predictive value was 0.63 (95% CI, 0.50–0.74), and negative predictive value was 0.89 (95% CI, 0.82–0.93). Positive likelihood ratio was 4.35 (95% CI, 2.87–6.61), and negative likelihood ratio was 0.33 (95% CI, 0.21–0.52). Magnetic resonance imaging improved the sensitivity and negative predictive value of endometrial biopsy alone in predicting women with endometrial cancer who require full surgical staging (0.73 vs 0.65 and 0.80 vs 0.78, respectively).ConclusionsPreoperative pelvic MRI is a moderately sensitive and specific method of identifying invasion to the outer half of myometrium in endometrial cancer. Addition of MRI to preoperative assessment leads to improved preoperative assessment, triage, and treatment.

scholarly journals High resolution diffusion-weighted imaging with readout segmentation of long variable echo-trains for determining myometrial invasion in endometrial carcinoma

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mengnv Xie ◽  
Zhen Ren ◽  
Dujun Bian ◽  
Dan Li ◽  
Li Yu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Image Quality ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Diffusion Weighted Imaging ◽  
Myometrial Invasion ◽  
Single Shot ◽  
Diffusion Weighted ◽  
Noise Ratio

Abstract Background We assessed the image quality of endometrial cancer lesions by readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) compared with that by single-shot echo-planar imaging (SS-EPI) DWI, aimed to explore the value of RESOLVE DWI for determining myometrial invasion and clinical stage in endometrial cancer. Materials and methods From April 2017 to March 2018, a total of 30 endometrial cancer patients (mean age 52.8 ± 9.0 years), who had undergone RESOLVE DWI and SS-EPI DWI, were included in the study. The image quality of endometrial carcinoma by two kinds of DWI scanning methods was compared qualitatively and quantitatively. The Spearman rank correlation test was used to assess the correlation of qualitative image quality scores between two readers. The accuracy of two DWI methods in detecting myometrial invasion and staging of endometrial carcinoma was calculated according to postoperative pathological results. The indexes were analyzed including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). Results The qualitative score of RESOLVE DWI group was superior to SS-EPI DWI group in every aspect of five aspects (all P < 0.001). Interobserver agreement of depiction was good or excellent in two DWI sequences. Signal to noise ratio and contrast to noise ratio values in RESOLVE DWI group were both higher than those in SS-EPI DWI group (P<0.001). No statistical difference of apparent diffusion coefficient value was observed between two DWI groups (P = 0.261). The specificity, accuracy, PPV, and NPV of estimating myometrial invasion by RESOLVE DWI in three cases (intramucosal lesion, <50% superficial invasion and ≥ 50% deep invasion) were all higher than those by SS-EPI DWI for endometrial carcinoma. Especially RESOLVE DWI was valuable in judging <50% superficial invasion (95%CI:0.586, 0.970). No significant difference in accuracy staging was between the two DWI groups (P = 0.125). Conclusion RESOLVE DWI can provide higher quality images of endometrial carcinoma than SS-EPI DWI. The high-quality images are helpful for precise assessment of myometrial invasion in endometrial cancer.

Added Value of Diffusion-Weighted Imaging in Endometrial Cancer

2018 ◽  
pp. 147-166
Author(s):  
Stephanie Nougaret ◽  
Helen Addley ◽  
Mariana Horta ◽  
Teresa Margarida Cunha ◽  
Evis Sala
Keyword(s):  
Endometrial Cancer ◽  
Diffusion Weighted Imaging ◽  
Added Value ◽  
Diffusion Weighted

Role of Various DW MRI and DCE MRI Parameters as Predictors of Malignancy in Solid Pulmonary Lesions

2020 ◽  
pp. 084653712091489
Author(s):  
Neeraj Kumar ◽  
Mini Sharma ◽  
Neeti Aggarwal ◽  
Sanjiv Sharma ◽  
Malay Sarkar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diffusion Weighted Imaging ◽  
Breath Hold ◽  
Data Set ◽  
Predictive Values ◽  
Pulmonary Lesions ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced

Purpose: We aimed to evaluate various diffusion and dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) parameters in differentiating malignant from benign pulmonary lesions. Methods: We enrolled 31 (22 males) patients who had solid pulmonary lesion(s) >2 cm in our cross sectional study. Of these, 23 (74.2%) were found to be malignant on histopathology. Dynamic contrast-enhanced MRI was performed using 36 dynamic measurements (volumetric interpolated breath-hold examination). Diffusion-weighted MRI (DW MRI) performed at b value of 800 s/mm2. We measured different diffusion and perfusion parameters, for example, diffusion-weighted imaging (DWI) SI, mean apparent diffusion coefficient (ADC), minimum ADC, lesion-to-spinal cord ratio, DWI score, T2 score, Ktrans, Kep, and Ve. We stratified values of each parameter as high if it was >median of values observed in our data set and low if it was ≤median. Normally distributed data were compared by unpaired t test, whereas non-normal continuous data were compared by Kruskal Wallis-H test. We applied Wilson score method to calculate sensitivity, specificity, and predictive values of parameters that were statistically significant by type of lesion with reference to histopathological examination as gold standard. Results: Diffusion-weighted imaging SI, mean ADC, minimum ADC, DWI score and Ktrans values were found to be significantly different ( P value < .05) by type of lesion. Ktrans was found to have the highest diagnostic accuracy (74.2%) among these parameters. Conclusion: Ktrans and mean ADC had similar sensitivity of 65.2%. However, Ktrans had highest diagnostic accuracy among various DWI and DCE MRI parameters in predicting malignancy in solid pulmonary lesions. In our study, we found a cutoff value 0.251 min−1 for Ktrans as 100% specific.

scholarly journals Staging of Endometrial Cancer Using Fusion T2-Weighted Images with Diffusion-Weighted Images: A Way to Avoid Gadolinium?

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 384
Author(s):  
Teresa Resende Neves ◽  
Mariana Tomé Correia ◽  
Maria Ana Serrado ◽  
Mariana Horta ◽  
António Proença Caetano ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Diagnostic Accuracy ◽  
Myometrial Invasion ◽  
Acquisition Time ◽  
Pelvic Mri ◽  
Diffusion Weighted Images ◽  
Diffusion Weighted ◽  
Experienced Radiologist ◽  
Mri Protocol ◽  
T2 Weighted Images

Endometrial cancer is the eighth most common cancer worldwide, and its prognosis depends on various factors, with myometrial invasion having a major impact on prognosis. Optimizing MRI protocols is essential, and it would be useful to improve the diagnostic accuracy without the need for other sequences. We conducted a retrospective, single-center study, which included a total of 87 patients with surgically confirmed primary endometrial cancer, and who had undergone a pre-operative pelvic MRI. All exams were read by an experienced radiologist dedicated to urogenital radiology, and the depth of myometrial invasion was evaluated using T2-Weighted Images (T2WI) and fused T2WI with Diffusion-Weighted Images (DWI). Both results were compared to histopathological evaluations. When comparing both sets of imaging (T2WI and fused T2WI-DWI images) in diagnosing myometrial invasion, the fused images had better accuracy, and this difference was statistically significant (p < 0.001). T2WI analysis correctly diagnosed 82.1% (70.6–88.7) of cases, compared to 92.1% correctly diagnosed cases with fused images (79.5–97.2). The addition of fused images to a standard MRI protocol improves the diagnostic accuracy of myometrial invasion depth, encouraging its use, since it does not require more acquisition time.

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