Diffusion-weighted MRI in the differential diagnosis of uterine endometrial cavity tumors.

ABSTRACT

BACKGROUND: This study aimed to investigate the efficacy of quantitative apparent diffusion coefficient (ADC) measurement in the differential diagnosis of the uterine endometrial cavity tumors (UECT). METHODS: This study included consecutive 36 female patients with UECT. The groups were formed as follows group 1, patients with endometrial carcinoma; group 2, patients with endometrial polyp; group 3, patients with submucosal leiomyoma; and additionally group A, patients with malignant lesion; group B patients with benign lesion. Tumoral and outer myometrial ADC values were measured and the tumor-myometrium ADC ratios were calculated in all patients. Kolmogorov-Smirnov tests were used to test the normality of the data distributions. The data were not normally distributed, and therefore, nonparametric tests were performed. The cut-off values, sensitivity, and specificity were determined by the receiver operating characteristic analysis. RESULTS: The mean ADC value and ratio of group 1 were lower than that of group 2 and 3, and the mean ADC value and ratio of group 3 were lower than that of group 2. The sensitivity and specificity for group 1, 2, and 3 were as follows 90, 100, and 66.7 %; and 81.8, 88, and 58.8 %, respectively, in terms of the ADC values; 90, 100 and 67 %; and 77.3, 96, and 64.7 % in terms of the ADC ratios. Statistically significant differences were demonstrated between group A and B in terms of mean tumoral ADC values and ratios. Sensitivity and specificity were found to be 90 and 81.8 %, respectively, in terms of the ADC values. The sensitivity and specificity were found to be 90 and 77.3 %, respectively, in terms of the ADC ratios. CONCLUSIONS: ADC values and ratios represent a promising parameter in the determination of the tumoral lesions in patients with UECT.