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- Title
Endometrial cancer with cervical stromal invasion: diagnostic accuracy of diffusion-weighted and dynamic contrast enhanced MR imaging at 3T.
- Authors
Lin, Gigin; Huang, Yu-Ting; Chao, Angel; Lin, Yu-Chun; Yang, Lan-Yan; Wu, Ren-Chin; Lu, Hsin-Ying; Ng, Shu-Hang; Ng, Koon-Kwan; Lai, Chyong-Huey
- Abstract
<bold>Objectives: </bold>To compare the diagnostic accuracy of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging for detecting cervical stromal invasion in endometrial cancer.<bold>Methods: </bold>Eighty-three consecutive women with endometrial cancer underwent preoperative evaluation in a 3-T unit, including T2-weighted, DW (b = 0 and 1000 s/mm2), and DCE MR imaging. Two radiologists independently assessed presence of cervical stromal invasion, with histopathological reference as gold standard.<bold>Results: </bold>For assessing cervical stromal invasion, the diagnostic accuracy, sensitivity, and specificity, respectively for Reader 1/Reader 2, were as follows: DW MR imaging- 95.2 %/91.6 %, 91.7 %/100 %, and 95.8 %/90.1 %; DCE MR imaging- 91.6 %/88 %, 58.3 %/50 %, and 97.2 %/94.4 %. The diagnostic performance of DW MR imaging (Reader 1: areas under the receiver operating characteristic curve (AUC) = 0.98; Reader 2: AUC = 0.97) was significantly higher than that of DCE MR imaging (p = 0.009 for Reader 2) or T2-weighted MR imaging (Reader 1: p = 0.006; Reader 2: p = 0.013). Patients with cervical stromal invasion showed a significantly greater canal width (p < 0.0001) and myometrial invasion extent (p = 0.006).<bold>Conclusions: </bold>DW MR imaging has superior diagnostic performance compared with DCE MR imaging in the detection of cervical stromal invasion.<bold>Key Points: </bold>• DWI demonstrates a higher accuracy than DCE in detecting cervical stromal invasion. • Tumour ADC values are similar between patients without or with cervical invasion. • Canal widening causes false-negativity on DCE and T2W but not on DWI.
- Subjects
DIAGNOSIS of endometrial cancer; TREATMENT of endometrial cancer; MYOMETRIUM; DIFFUSION magnetic resonance imaging; MAGNETIC resonance imaging; CANCER invasiveness; COMPARATIVE studies; DIFFERENTIAL diagnosis; RESEARCH methodology; MEDICAL cooperation; PREOPERATIVE care; RESEARCH; RESEARCH evaluation; UTERINE tumors; ENDOMETRIAL tumors; EVALUATION research; CONTRAST media; RECEIVER operating characteristic curves
- Publication
European Radiology, 2017, Vol 27, Issue 5, p1867
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4583-0