Myometrial invasion in trial cancer: Diagnostic accuracy of diffusion-weighted 3.0-T MR imaging-initial experience

Gigin Lin, Koon Kwan Ng, Chee Jen Chang, Jiun Jie Wang, Kung Chu Ho, Tzu Chen Yen, Tzu I. Wu, Chun Chieh Wang, Yu Ruei Chen, Yu Ting Huang, Shu Hang Ng, Ting Chang Chang, Chyong Huey Lai, Shih Ming Jung

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Abstract

Purpose: To assess the diagnostic accuracy of fused T2-weighted and high-b-value diffusion-weighted (DW) magnetic resonance (MR) images at 3 T for evaluation of myometrial invasion in patients with endometrial cancer. Materials and Methods: Institutional review board approval and informed consent were obtained. From May 2006 to October 2007, 48 consecutive patients aged 25-80 years (mean age, 57 years) who had endometrial cancer were prospectively enrolled for preoperative evaluation by using a 3-T MR unit. Two radiologists interpreted the depth of myometrial invasion on T2-weighted images, dynamic contrast material-enhanced MR images, and fused T2-weighted and DW MR images (b = 1000 sec/mm2). Statistical methods included k statistics for reader agreement, Pearson analysis for pathologic correlation, accuracy assessment, and receiver operating characteristic analysis for diagnostic performance comparison. Surgical pathologic findings were the reference standard. Results: Reader agreement was excellent for fused T2-weighted and DW images (weighted k, 0.79), with a significant pathologic correlation regarding the depth of myometrial invasion (r = 0.94, P <.0001). For assessing any myometrial involvement, addition of fused T2-weighted and DW imaging to dynamic contrast-enhanced or dynamic contrast-enhanced and T2-weighted imaging was significantly better compared with dynamic contrast-enhanced imaging alone (P <.001) or dynamic contrast-enhanced and T2- weighted (P = .001) imaging; T2-weighted imaging combined with fused T2-weighted and DW imaging also was better than dynamic contrast-enhanced and T2-weighted imaging (P = .001). Tumor apparent diffusion coefficients were 0.60-1.32 × 10-3 mm2/sec (median, 0.75 × 10-3 mm2/sec), with no significant correlation with the depth of myometrial invasion (P = .31, r = -0.15). Conclusion: Fused T2-weighted and high-b-value DW images at 3 T can provide accurate information for preoperative evaluation of myometrial invasion.

Original languageEnglish
Pages (from-to)784-792
Number of pages9
JournalRadiology
Volume250
Issue number3
DOIs
Publication statusPublished - Mar 2009
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Lin, G., Ng, K. K., Chang, C. J., Wang, J. J., Ho, K. C., Yen, T. C., Wu, T. I., Wang, C. C., Chen, Y. R., Huang, Y. T., Ng, S. H., Chang, T. C., Lai, C. H., & Jung, S. M. (2009). Myometrial invasion in trial cancer: Diagnostic accuracy of diffusion-weighted 3.0-T MR imaging-initial experience. Radiology, 250(3), 784-792. https://doi.org/10.1148/radiol.2503080874