Endometrial Cancer: Correlation of Apparent Diffusion Coefficient With Tumor Grade, Depth of Myometrial Invasion, and Presence of Lymph Node Metastases

2011 ◽  
Vol 197 (1) ◽  
pp. 256-262 ◽  
Author(s):  
Gilda Rechichi ◽  
Stefania Galimberti ◽  
Mauro Signorelli ◽  
Cammillo Talei Franzesi ◽  
Patrizia Perego ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Apparent Diffusion Coefficient ◽  
Lymph Node Metastases ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Apparent Diffusion ◽  
Node Metastases

scholarly journals Associations Between Apparent Diffusion Coefficient Value With Pathological Type, Histologic Grade, and Presence of Lymph Node Metastases of Esophageal Carcinoma

2019 ◽  
Vol 18 ◽  
pp. 153303381989225
Author(s):  
Yating Wang ◽  
Genji Bai ◽  
Lili Guo ◽  
Wei Chen
Keyword(s):  
Diffusion Coefficient ◽  
Lymph Node ◽  
Apparent Diffusion Coefficient ◽  
Esophageal Carcinoma ◽  
Lymph Node Metastases ◽  
Histologic Grade ◽  
Pathological Type ◽  
Apparent Diffusion Coefficient Value ◽  
Apparent Diffusion ◽  
Node Metastases

Objective: To investigate the application value of apparent diffusion coefficient value in the pathological type, histologic grade, and presence of lymph node metastases of esophageal carcinoma. Materials and Methods: Eighty-six patients with pathologically confirmed esophageal carcinoma were divided into different groups according to pathological type, histological grade, and lymph node status. All patients underwent conventional magnetic resonance imaging and diffusion-weighted imaging scan, and apparent diffusion coefficient values of tumors were measured. Independent sample t test and 1-way variance were used to compare the difference of apparent diffusion coefficient value in different pathological types, histologic grades, and lymph node status. Correlation between the apparent diffusion coefficient value and the histologic grade was evaluated using Spearman rank correlation test. Receiver operating characteristic curve of apparent diffusion coefficient value was generated to evaluate the differential diagnostic efficiency of poorly and well/moderately differentiated esophageal carcinoma. Results: No significant difference was observed in apparent diffusion coefficient value between esophageal squamous cell carcinoma and adenocarcinoma and in patients between those with and without lymph node metastases ( P > .05). The differences of apparent diffusion coefficient value were statistically significant between different histologic grades of esophageal carcinoma ( P < .05). The apparent diffusion coefficient value was positively correlated with histologic grade ( rs = 0.802). The apparent diffusion coefficient value ≤1.25 × 10−3 mm2/s as the cutoff value for diagnosis of poorly differentiated esophageal carcinoma with the sensitivity of 84.3%, and the specificity was 94.3%. Conclusions: The performance of apparent diffusion coefficient value was contributing to predict the histologic grade of esophageal carcinoma, which might increase lesions characterization before choosing the best therapeutic alternative. However, they do not correlate with pathological type and the presence of lymph node metastases of esophageal carcinoma.

The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

2020 ◽  
Vol 61 (9) ◽  
pp. 1277-1286
Author(s):  
Juan Armando Reyes-Pérez ◽  
Yolanda Villaseñor-Navarro ◽  
Mayra Evelia Jiménez de los Santos ◽  
Irlanda Pacheco-Bravo ◽  
Maricela Calle-Loja ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Apparent Diffusion Coefficient ◽  
Histological Grade ◽  
Myometrial Invasion ◽  
Region Of Interest ◽  
Tumor Grade ◽  
Invasion Depth ◽  
Additional Information ◽  
Apparent Diffusion

Background Diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) measurement provides additional information about tumor microstructure with potential relevance for staging and predicting aggressive disease in patients with endometrial cancer (EC). Purpose To determine whether ADC values in EC diverge according to the tumor’s histologic grade and myometrial invasion depth. Material and Methods A sample of 48 pathologically confirmed cases of EC were reviewed retrospectively. The sample was distributed as follows: G1 (n = 9); G2 (n = 18); G3 (n = 21); with myometrial invasion <50% (n = 31); and with myometrial invasion ≥50% (n = 17). DW images were performed at 3.0T with b factors of 0–1000/mm2. The region of interest (ROI) was defined within the tumor with T1-weighted and T2-weighted imaging and copied manually to an ADC map. The tumor’s grade and myometrial invasion’s depth were determined by postoperative histopathological tests. Results The means of ADCmin and ADCmean values were significantly lower for patients with G2 and G3 endometrial tumors than G1. The same tendency was observed in myometrial invasion, as both ADCmin and ADCmean values were lower for patients with deep than for those with superficial myometrial invasion. The cut-off values of the ADCmin and ADCmean that predicted high-grade tumors were 0.69 × 10−3 mm2/s and 0.82 × 10−3 mm2/s, respectively, while those for myometrial infiltration were 0.70 × 10−3 mm2/s (ADCmin) and 0.88 × 10−3 mm2/s (ADCmean). Conclusion ADCmin and ADCmean values correlated with histologic tumor grade and myometrial invasion depth; therefore, it is suggested that ADC on MRI may be a useful indicator to predict malignancy of ECs.

Endometrial cancer: correlation of apparent diffusion coefficient (ADC) with tumor cellularity and tumor grade

2015 ◽  
Vol 57 (8) ◽  
pp. 1021-1028 ◽  
Author(s):  
Keiko Kishimoto ◽  
Shinya Tajima ◽  
Ichiro Maeda ◽  
Masayuki Takagi ◽  
Takahiko Ueno ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Apparent Diffusion Coefficient ◽  
Tumor Grade ◽  
Apparent Diffusion

Is the standard deviation of the apparent diffusion coefficient a potential tool for the preoperative prediction of tumor grade in endometrial cancer?

2020 ◽  
Vol 61 (12) ◽  
pp. 1724-1732
Author(s):  
Bin Yan ◽  
Xiufen Liang ◽  
Tingting Zhao ◽  
Caixia Ding ◽  
Ming Zhang
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Standard Deviation ◽  
Apparent Diffusion Coefficient ◽  
Tumor Grade ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Preoperative Prediction ◽  
Apparent Diffusion

Background The tumor histological grade is closely related to the prognosis of endometrial cancer (EC). The use of the apparent diffusion coefficient (ADC), tumor volume, and MRI-based texture analysis has allowed exciting advances in predicting EC grade before surgery. However, whether this constitutes a simple, convenient, and powerful diagnostic method remains unknown. Purpose To explore the utility of standard deviation (SD) of the ADC (ADCSD) for predicting the tumor grade in patients with EC. Material and Methods We retrospectively evaluated 138 patients with EC. All patients underwent unenhanced MRI and diffusion-weighted imaging (DWI). The mean ADC value (ADCmean) and SD were obtained using a freehand region of interest traced on the ADC map. Spearman’s linear correlation coefficients were calculated to analyze the correlations between the indexes (including ADCSD and the ADCmean) and the Ki-67 index. The Kruskal–Wallis and Mann–Whitney U tests were used to compare differences in the index results among tumor grades. Results A significant difference in ADCSD was observed among the tumor grades ( P=0.000), and the ADCSD value was significantly higher for high-grade EC than for low-grade tumors (289.7 vs. 216.3×10−6mm2 /s, P=0.000). A statistically significant positive correlation was observed between ADCSD and the Ki-67 index (r=0.364, P=0.000). According to the receiver operating characteristic curve, ADCSD ≥240.2×10−6mm2 /s predicted high-grade EC with a sensitivity, specificity, and accuracy of 73.1%, 80.2%, and 77.5%, respectively. Conclusion Based on the intratumor heterogeneity of EC, ADCSD represents a potential method for the preoperative prediction of high-grade EC, although further studies are needed.

Correlation between clinical and histopathologic risk factors and lymph node metastases in early endometrial cancer (a multivariate analysis of 183 cases)

1994 ◽  
Vol 4 (5) ◽  
pp. 306-309 ◽  
Author(s):  
A. Ayhan ◽  
R. Tuncer ◽  
Z. S. Tuncer ◽  
K. YÜCe ◽  
T. KÜÇÜKali
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Clinical Stage ◽  
Myometrial Invasion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lymph Node Status ◽  
Peritoneal Cytology ◽  
Node Metastases

This study includes 183 patients with clinical stage I endometrial cancer subjected to peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic and para-aortic lymphadenectomy and omental biopsy during a 12-year period in a single institution. The factors analyzed were age, menopausal state, cell type, grade, mitotic activity, myometrial invasion, lymphovascular space invasion, cervical involvement, microscopic vaginal metastases, adnexal metastases, peritoneal cytology, presence of concomitant endometrial hyperplasia and lymph node status. The overall incidences of pelvic and para-aortic lymph node metastases were found to be 15.3% (28/183) and 9.3% (17/183), respectively. In five of 17 patients (29.4%) with para-aortic nodal metastases, pelvic nodes were free of tumor. The most significant prognostic factors for positive pelvic and/or para-aortic nodes were found to be the depth of myometrial invasion, grade of tumor and age.

scholarly journals Clinical Impact of Preoperative Magnetic Resonance Imaging in the Evaluation of Myometrial Infiltration and Lymph-Node Metastases in Stage I Endometrial Cancer

2021 ◽  
Vol 27 ◽  
Author(s):  
Dorottya Bús ◽  
Gyöngyi Nagy ◽  
Róbert Póka ◽  
György Vajda
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Positive Predictive Value ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
False Positive ◽  
Myometrial Invasion ◽  
Node Metastases ◽  
Sensitivity Specificity ◽  
Positive Results

Abstract: Purpose: In the developed world, endometrial cancer is one of the most common malignant gynecological cancer types. Due to the highly available diagnostic modalities and patient education, the early detection of the tumor leads to high overall survival.Methods: In this study we analyzed the reliability of preoperative MRI findings in the staging of early stage endometrial cancer, as well as the clinical characteristics of patients underwent radical hysterectomy and the histopathologic evaluation of their tumor, with the retrospective data of radical hysterectomies performed in our hospital between 2010 and 2019.Results: The accuracy, sensitivity, specificity, negative- and positive predictive value of MRI regarding stage were 94.7, 63.3, 94.8, 83.8, and 83.8%, respectively. The accuracy, sensitivity, specificity, negative- and positive predictive value of MRI for the detection of the myometrial invasion were 69.8, 80.0, 60.8, 64.3, and 77.5%, respectively. The accuracy, sensitivity, specificity, negative- and positive predictive value of MRI for the detection of lymph node metastases were 78.1, 28.6, 82, 11.1, and 93.6%, respectively.Conclusions: Based on our results, MRI is the method of choice in terms of evaluating overall staging, as well as myometrial invasion, as its specificity and negative predictive value are relatively high. However, systematic lymphadenectomy showed improved cancer-related survival and recurrence-free survival. Our studies showed that the diagnosis of lymph node metastases is difficult with MRI modality since hyperplastic and metastatic nodes cannot easily differentiate, leading to a high percentage of false-positive results. Therefore, other imaging modalities may be used for more accurate evaluation. New findings of our study were that the role of the radiologist’s expertise in the evaluation of MR imaging plays an essential role in lowering false-negative and false-positive results. Therefore, findings evaluated by a radiologist with high-level expertise in gynecological imaging can complement the clinical findings and help substantially define the needed treatment.

Depth of myometrial invasion to predict lymph node metastases in women with endometrial cancer

2011 ◽  
Vol 123 (2) ◽  
pp. 432-433 ◽  
Author(s):  
J. Pittman ◽  
A.P. Soisson ◽  
M.K. Dodson ◽  
J. Webb ◽  
J. Hunn ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Myometrial Invasion ◽  
Node Metastases

scholarly journals Ultrasound Measurement of Tumor-Free Distance from the Serosal Surface as the Alternative to Measuring the Depth of Myometrial Invasion in Predicting Lymph Node Metastases in Endometrial Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1472
Author(s):  
Marcin Liro ◽  
Marcin Śniadecki ◽  
Ewa Wycinka ◽  
Szymon Wojtylak ◽  
Michał Brzeziński ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Transvaginal Ultrasound ◽  
Multivariable Analysis ◽  
Myometrial Invasion ◽  
Ultrasound Measurement ◽  
Lymph Node Status ◽  
Free Distance ◽  
Node Metastases

Background: Ultrasonography’s usefulness in endometrial cancer (EC) diagnosis consists in its roles in staging and prediction of metastasis. Ultrasound-measured tumor-free distance from the tumor to the uterine serosa (uTFD) is a promising marker for these diagnostic and prognostic variables. The aim of the study was to determine the usefulness of this biomarker in locoregional staging, and thus in the prediction of lymph node metastasis (LNM). Methods: We conducted a single-institutional, prospective study on 116 consecutive patients with EC who underwent 2D transvaginal ultrasound examination. The uTFD marker was compared with the depth of ultrasound-measured myometrial invasion (uMI). Univariable and multivariable logit models were evaluated to assess the predictive power of the uTFD and uMI in regard to LNM. The reference standard was a final histopathology result. Survival was assessed by the Kaplan–Meier method. Results: LNM was found in 17% of the patients (20/116). In the univariable analysis, uMI and uTFD were significant predictors of LNM. The accuracy was 70.7%, and the NPV was 92.68% (OR 4.746, 95% CI 1.710–13.174) for uMI (p = 0.002), and they were 63.8% and 89.02% (OR 0.842, 95% CI 0.736–0.963), respectively, for uTFD (p = 0.01). The cutoff value for uTFD in the prediction of LNM was 5.2 mm. The association between absence of LNM and biomarker values of uMI < 1/2 and uTFD ≥ 5.2 mm was greater than that between the presence of metastases and uMI > 1/2 and uTFD values <5.2 mm. In the multivariable analysis, the accuracy of the uMI–uTFD model was 74%, and its NPV was 90.24% (p = non-significant). Neither uMI nor uTFD were surrogates for overall and recurrence-free survivals in endometrial cancer. Conclusions: Both uMI and uTFD, either alone or in combination, were valuable tools for gaining additional preoperative information on expected lymph node status. Negative lymph nodes status was better described by ultrasound biomarkers than a positive status. It was easier to use the uTFD rather than the uMI measurement as a biomarker of EC invasion, and the former still maintained a similar predictive value for lymph node metastases to the latter at diagnosis.

scholarly journals Prognostic factors in endometrial cancer

2013 ◽  
Vol 35 (1) ◽  
pp. 9-17
Author(s):  
SR Bajracharya ◽  
FY Juan
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Gynecological Cancer ◽  
Menopausal Status ◽  
Female Genital Tract ◽  
Myometrial Invasion ◽  
Peritoneal Cytology ◽  
Node Metastases

Introduction: Endometrial cancer (EC) is the most common malignancy of the female genital tract. It is now the fourth most common gynecological cancer among women and the sixth worldwide cancer in Western countries. It is the most curable of the 10 most common cancers in women and the most frequent and curable of the gynecologic cancers. The incidence is increasing when life expectancy rise. This study was carried out to evaluate the prognostic factors of Endometrial Cancer. Methods: Clinico-pathological characteristics and follow-up cases of endometrial cancer were analysed retrospectively between January 2000 to December 2007 with its prognostic factors influence were statistically analysed. Results: During the study period total 180 patients were taken. Univariate model revealed that the menopausal status, the FIGO stage, grade, histological type, myometrial invasion, ER, PR, peritoneal cytology, lymph node metastases, adjuvant therapy, and the method of operation were related with the prognosis significantly. The multivariate analysis Cox proportion hazards regression model showed that the ER (P=0.004), PR (P=0.000), myometrial invasion (P=0.006) and lymph node metastases (P=0.049) were related with the prognosis significantly. Conclusion: The clinico-pathological character of endometrial cancer is responsible for patient’s better survival. If the patients had early detection and treated in proper modalities, this might improve the good prognosis. DOI: http://dx.doi.org/10.2126/joim.v35i1.8891    Journal of Institute of Medicine, April, 2013; 35:9-17

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