Computed Tomography Optic Nerve Sheath Diameter-to-Eyeball Transverse Diameter Ratio as a Novel Noninvasive Parameter for Prognostication in Traumatic Brain Injury.

Background Traumatic brain injury (TBI) remains a foremost cause of death and disability globally, with elevated intracranial pressure (ICP) being a crucial factor in patient outcomes. While invasive monitoring is the gold standard for assessing ICP, it carries risks and is not always feasible. This study proposes a novel noninvasive parameter using computed tomography (CT) imaging. Aims and objectives The study aims to determine the efficacy of the optic nerve sheath diameter (ONSD)-to-eyeball transverse diameter (ETD) ratio from CT scans in predicting TBI patients' prognosis. The primary objective is to study the ONSD/ETD ratio's efficacy in assessing TBI's severity. The secondary objective is to correlate the ONSD/ETD ratio with the Glasgow Coma Scale (GCS) and Rotterdam computed tomography scoring (RCTS) and assess its clinical benefit. Materials and methods This combined retrospective and prospective analytical study included 308 consecutive patients who underwent CT imaging for TBI at a tertiary care center with a dedicated trauma and neurosurgical unit. We evaluated bilateral ONSD and ETD using axial CT scans. The ONSD/ETD ratio correlated with the GCS, RCTS, and clinical outcomes. Results The cut-off values for elevated ICP were ONSD of >5.17 mm, ETD of <22.2 mm, and ONSD/ETD ratio of >0.21. Variables between GCS (<12 and >12) and the ONSD/ETD ratio (<0.21 and >0.21) were statistically significant (chi-square {χ2} = 18.52, p = 0.000). The ONSD shows a strong positive correlation with RCTS (r = 0.82, p = 0.01), ETD shows a moderate negative correlation with RCTS (r = -0.50), and the ONSD/ETD ratio shows a strong negative correlation with GCS (r = -0.783, p = 0.01). The area under the curve for the ONSD/ETD ratio (0.920) was higher than that for ONSD (0.932) and ETD (0.490). The ONSD/ETD ratio's sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 95.6%, 72.0%, and 100%, respectively, demonstrating that it is an excellent predictor of raised ICP. Conclusion The CT-ONSD/ETD ratio correlates with the severity of TBI as assessed by GCS and RCTS. It could serve as a noninvasive parameter for monitoring ICP and guiding the need for sequential CT in TBI patients, potentially aiding in prognostication and clinical management.

Integrated analysis of rectal mucosal microbiome and transcriptome reveals a distinct microenvironment among young MSM.

Cross-talk between the microbiome and gut mucosa-resident immune cells plays a pivotal role in modulating immune responses to pathogens, including responses to HIV infection. However, how these interactions may differ between young MSM (YMSM) disproportionately impacted by HIV, as compared to older adult MSM (AMSM), is not well understood. A broad analysis of associations between the microbiome and rectal transcriptome revealed 10 microbial families/genera correlated with immunologic gene pathways. Specifically, the rectal transcriptome of YMSM is characterized by upregulation of T cell activation/differentiation pathways and signaling from multiple cytokine families, compared to AMSM. The microbiome of YMSM is enriched with pathogenic genera including Peptostreptococcus, shown to be positively correlated with type I interferon pathways important for antiviral immunity. These findings demonstrate that YMSM have a unique immune phenotype and rectal microenvironment and support further evaluation of biological factors that influence rectal HIV transmission.

An injectable hydrogel of porcine cholecyst extracellular matrix for accelerated wound healing.

Hydrogel formulations of xenogeneic extracellular matrices have been widely used for topical wound care because of their exceptional tunability over other formulations like lyophilized sheets, powders, non-injectable gels, pastes, and ointments. This is important in the treatment of wounds with irregular shapes and depth. This study identified an injectable hydrogel formulation of porcine cholecyst extracellular matrix (60%) in medical-grade carboxymethyl cellulose (40%) as vehicle and evaluated its biomaterial properties. Further, an in-depth evaluation of in vivo wound healing efficacy was conducted in a rat full-thickness skin excision wound healing model, which revealed that the hydrogel formulation accelerated wound healing process compared to wounds treated with a commercial formulation and untreated wounds. The hydrogel appeared to have promoted a desirable pro-regenerative tissue reaction predominated by Th2 helper lymphocytes and M2 macrophages as well as an effective collagen remodeling indicative of diminished scarring. In conclusion, the porcine cholecyst extracellular matrix injectable hydrogel formulation appeared to be a promising candidate formulation as an advanced wound care biomaterial for faster healing of skin wounds with minimal scarring.

Intensive care unit admission rates and factors associated following Autologous stem cell transplantation-real-world experience from a tertiary center in rural India.

PURPOSE: Infectious and other complications can necessitate admission to the intensive care unit (ICU) in autologous stem cell transplantation (ASCT). Data on need for ICU care, impact of various pre- and peri-transplant characteristics on requirement of ICU care and outcomes are scarce from the developing world. METHODS: A retrospective case record review of ASCT cases was conducted. Pre- and peri-transplant characteristics like infection within 4 weeks of transplant, mucositis, surveillance culture positivity, peri-transplant infections, comorbidity, and time to neutrophil and platelet engraftment were noted. RESULTS: A total of 109 patients underwent 109 ASCTs. Most common diagnosis was the plasma cell disorder in 75 (69%) patients. Forty-eight (45%) patients had peri-transplant infections. Fifteen (14%) patients had infections with multi-drug resistant (MDR) organisms. Fifteen (14%) patients required ICU care, the most common reason being hypotension in nine patients (8.3%). Four patients (3.7%) required non-invasive ventilation, and one (0.9%) required invasive ventilation. Mortality rate was 1.8% (two patients). Factors associated with the need for ICU care were time to platelet engraftment (median 15 days among those required ICU care versus 13 days who did not, p = 0.04) and presence of peri-transplant infection showed a trend toward ICU care need (19% among those required ICU care versus 7% in those who did not, p = 0.05). CONCLUSION: Delayed platelet engraftment was associated with the need for ICU care and peri-transplant infections were associated with a trend toward need for ICU care.

ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine.

Gender disparity in Critical Care Medicine (CCM) persists globally, with women being underrepresented. Female Intensivists remain a minority, facing challenges in academic and leadership positions at the workplace and within academic societies. The Indian Society of Critical Care Medicine (ISCCM) recognized the need for addressing issues related to gender parity and constituted its first Diversity Equity and Inclusion (DEI) Committee in 2023. Through a Delphi process involving 38 Panelists including 53% women, consensus and stability were achieved for 18 statements (95%). From these 18 consensus statements, 15 position statements were drafted to address gender balance issues in CCM. These statements advocate for equal opportunities in recruitment, workplace inclusivity, prevention of harassment, and improved female representation in leadership roles, nominated positions, and conferences. While the consensus reflects a significant step toward gender equity, further efforts are required to implement, advocate, and evaluate the impact of these measures. The ISCCM position statements offer valuable guidance for promoting gender balance within society and the CCM community. How to cite this article: Sathe P, Shukla U, Kapadia FN, Ray S, Chanchalani G, Nasa P, et al. ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine. Indian J Crit Care Med 2024;28(S2):S288-S296.

Cobblestone lissencephaly (Type II), clinical, and neuroimaging: A case report and literature review.

Cobblestone lissencephaly (C-LIS) (TYPE II) is a rare and severe neuronal migration disorder characterized by a smooth brain surface with overmigrated neurons and abnormal formation of cerebral convolutions or gyri during fetal development, resulting in a cobblestone appearance. C-LIS is associated with eye anomalies and muscular dystrophy. This case report presents a detailed clinical and neuroimaging analysis of a patient diagnosed with cobblestone lissencephaly (Type II). It reviews pertinent literature to enhance our understanding of this complex condition. We report a case of a 6-year-old female child with cobblestone lissencephaly (C-LIS) (Type II) severe developmental delays, hypotonia, and recurrent intractable seizures. Magnetic resonance imaging (MRI) revealed a characteristic cobblestone appearance on the brain surface, indicative of abnormal neuronal migration. In addition to the classic findings of Type II Cobblestone lissencephaly, the patient displayed ventriculomegaly and cerebellar hypoplasia, contributing to the overall neurological impairment observed. The literature review highlights the genetic basis of cobblestone lissencephaly, emphasizing the involvement of genes associated with glycosylation processes and basement membrane integrity. Neuroimaging findings, including MRI and computed tomography scans, are crucial for accurate diagnosis and prognostication. Early identification of cobblestone lissencephaly allows for appropriate counseling and management strategies. However, the prognosis remains guarded, and interventions primarily focus on supportive care and seizure management. This case report contributes to the knowledge of cobblestone lissencephaly, shedding light on the clinical spectrum and neuroimaging features associated with this rare disorder. To clarify the underlying genetic mechanisms and possible therapeutic pathways for better patient outcomes, more investigation is necessary.

Evaluation of Prevention of Initial Enamel Lesions around Orthodontic Brackets by Using Different Remineralizing Agents: An Original Research.

Objective: The purpose of this study was to compare the efficacy of various remineralizing agents in stopping the early enamel lesions surrounding orthodontic brackets from progressing. Techniques: Four groups were randomly allocated to a total of 100 participants: the control group (no treatment), calcium phosphate, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish. Remineralizing chemicals were administered in accordance with manufacturer recommendations, and enamel lesions were created around orthodontic brackets. At baseline and follow-up visits, enamel lesion development was evaluated by visual inspection, quantitative light-induced fluorescence, and microhardness tests. Results: All treatment groups showed significant improvements in microhardness and decreases in lesion size compared to the control group (P < 0.05). Of all the treatment groups, CPP-ACP showed the most notable improvement in microhardness. Regarding the reduction of lesion size, there were no notable variations between the therapy groups (P > 0.05). Conclusion: Initial enamel lesions surrounding orthodontic brackets can be effectively prevented from progressing with the use of fluoride varnish, calcium phosphate, and CPP-ACP. Promising improvements in microhardness indicate that CPP-ACP may be a better treatment choice. Larger sample sizes and longer follow-up times are needed for future studies to validate these results and clarify the best strategy for maintaining the health of enamel throughout orthodontic treatment.

A cub and sushi domain-containing protein with esterase-like activity confers insecticide resistance in the Indian malaria vector Anopheles stephensi.

Chemical insecticides (organophosphates and pyrethroids) in the form of IRS (Indoor Residual Sprays) and LLINs (Long Lasting Insecticidal Nets) are the cornerstone for vector control, globally. However, their incessant use has resulted in widespread development of resistance in mosquito vectors, warranting continuous monitoring and investigation of the underlying mechanisms of resistance. Here, we identified a previously uncharacterized- Cub and Sushi Domain containing Insecticide Resistance (CSDIR) protein and generated evidence for its role in mediating insecticide resistance in the Anopheles stephensi. A strong binding affinity of the CSDIR protein towards different classes of insecticide molecules-malathion (KD 6.43 µM) and deltamethrin (KD 46.7 µM) were demonstrated using MD simulation studies and Surface Plasmon Resonance (SPR) experiments. Further, the recombinant CSDIR913-1190 protein exhibited potent esterase-like activity (α-naphthyl acetate (α-NA)- 1.356 ± 0.262 mM/min/mg and ß-naphthyl acetate (ß -NA)- 1.777 ± 0.220 mM/min/mg). Interestingly, dsRNA-mediated gene silencing of the CSDIR transcripts caused >60% mortality in resistant An. stephensi upon 1-h exposure to deltamethrin and malathion insecticides, compared to the control group. A significant reduction in the esterase-like activity was also observed against α-NA (p = 0.004) and ß-NA (p = 0.025) in CSDIR silenced mosquitoes compared to the control group. Using computational analysis and experimental data, our results provided significant evidence of the involvement of the CSDIR protein in mediating insecticide resistance in Anopheles mosquitoes. Thereby making the CSDIR protein, a novel candidate for exploration of novel insecticide molecules. These data would also be helpful in further understanding the development of metabolic resistance by the Anopheles vector.

Both GEF domains of the autism and developmental epileptic encephalopathy-associated Trio protein are required for proper tangential migration of GABAergic interneurons.

Recessive and de novo mutations in the TRIO gene are associated with intellectual deficiency (ID), autism spectrum disorder (ASD) and developmental epileptic encephalopathies (DEE). TRIO is a dual guanine nucleotide exchange factor (GEF) that activates Rac1, Cdc42 and RhoA. Trio has been extensively studied in excitatory neurons, and has recently been found to regulate the switch from tangential to radial migration in GABAergic interneurons (INs) through GEFD1-Rac1-dependent SDF1α/CXCR4 signaling. Given the central role of Rho-GTPases during neuronal migration and the implication of IN pathologies in ASD and DEE, we investigated the relative roles of both Trio's GEF domains in regulating the dynamics of INs tangential migration. In Trio-/- mice, we observed reduced numbers of tangentially migrating INs, with intact progenitor proliferation. Further, we noted increased growth cone collapse in developing INs, suggesting altered cytoskeleton dynamics. To bypass the embryonic mortality of Trio-/- mice, we generated Dlx5/6Cre;Trioc/c conditional mutant mice (TriocKO), which develop spontaneous seizures and behavioral deficits reminiscent of ASD and ID. These phenotypes are associated with reduced cortical IN density and functional cortical inhibition. Mechanistically, this reduction of cortical IN numbers reflects a premature switch to radial migration, with an aberrant early entry in the cortical plate, as well as major deficits in cytoskeletal dynamics, including enhanced leading neurite branching and slower nucleokinesis reflecting reduced actin filament condensation and turnover as well as a loss of response to the motogenic effect of EphA4/ephrin A2 reverse signaling. Further, we show that both Trio GEFD1 and GEFD2 domains are required for proper IN migration, with a dominant role of the RhoA-activating GEFD2 domain. Altogether, our data show a critical role of the DEE/ASD-associated Trio gene in the establishment of cortical inhibition and the requirement of both GEF domains in regulating IN migration dynamics.

Distribution of Normative Percentiles of Liver Stiffness Measurement Using Ultrasound Shear Wave Elastography in an Adult Asian Indian Population.

Objective The aim of this study was to determine the normative percentiles for liver stiffness measurement (LSM) using shear wave elastography in an adult Asian Indian population as part of the preventive radiology initiative of the Indian Radiological and Imaging Association (IRIA). Methods LSMs were ascertained by two-dimensional (2D) shear wave elastography using the Mindray Resona series of ultrasound machines. The image quality was assessed using the motion stability index (M-STB) and reliability (RLB) map. Ten acquisitions were documented, and an interquartile range-to-median (IQR/M) ratio ≤30% kilopascal (kPa) units was considered a good-quality measurement. A subgroup of the study population without comorbidities was chosen to derive the normative percentile distribution of LSM using a generalized least squares multivariable fractional polynomial regression model that adjusted for sex and body mass index (BMI). The effectiveness of the estimated percentiles was assessed on the entire study population using the greater than 90th percentile value of the LSM as the cutoff for abnormality. Results The study included 852 people who underwent shear wave elastography from June 2022 to July 2023. The magnitude of compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) was 6.81% (95% confidence interval [CI]: 5.30-8.7) and 4.91% (95% CI: 3.67-6.60), respectively. The normative percentiles were estimated from 282 persons without associated comorbidity and risk factors. The mean age (standard deviation [SD]) of the normal individuals was 40.90 ± 12.92 years, and 210 (71.47%) were males. The mean age (SD) of the 570 persons excluded from the normative percentiles analysis was 47.94 (12.49) years and 72.11% were males. The sex- and BMI-adjusted age-specific 90th percentiles of LSM were 8.76, 8.78, 8.96, 8.97, 9.25, and 9.45 kPa for 18 to 20, 21 to 30, 31 to 40, 41 to 50, 51 to 60, and 61 to 70 years, respectively. Conclusion The sex- and BMI-adjusted age-specific 90th percentiles for LSM using shear wave elastography in Asian Indian adults are almost similar to the greater than 9 kPa cutoff proposed by the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement guidelines to discriminate cACLD and CSPH from normal individuals.

Compliance with Low-Dose Aspirin and Outcomes in High-Risk Pregnant Women in Guna District of Central India.

Aim This article determines the compliance rates with low-dose aspirin (LDA) and outcomes in a group of pregnant women identified at high risk for preeclampsia (PE) and fetal growth restriction (FGR) at 11 to 14 gestational weeks (GWs) in a rural district of central India. Methods A single, experienced fetal radiologist assessed all enrolled pregnant women using trimester-specific antenatal screening protocols that included mean arterial blood pressure assessment, and fetal ultrasound and Doppler studies. A trimester-specific individualized risk for preterm PE and FGR was estimated for each woman. Pregnant women categorized as high risk for preterm PE or FGR based on a 1 in 150 criteria at 11 to 14 GW were recommended LDA 150 mg once daily at bedtime. Outcome measures included compliance with LDA assessed, incidence of PE and FGR, preterm delivery (<37 GW), birth weight, stillbirths, and perinatal mortality. Results The data of 488 pregnant women with longitudinal trimester-specific assessments from 11 to 14 GW till childbirth was analyzed. At the third trimester assessment, 215 (80.83%) of the high-risk women were compliant with LDA. The incidence of PE, FGR, and preterm births was significantly higher in LDA noncompliant women, and the mean birth weight was significantly higher in LDA-compliant high-risk women. Conclusion Good compliance for LDA is possible in rural populations with adequate counseling. Starting LDA at 11 to 14 GW for high-risk pregnant women lowered the incidence of PE, FGR, and preterm birth rates and improved birth weight in the study population.

Magnetic Resonance Imaging in the Assessment and Management of Post-injection-Site Morphea.

Morphea, a form of localized scleroderma, can significantly affect individuals by causing skin tightening and discoloration. We describe the case of a 22-year-old woman who presented with progressive skin changes and discomfort in her right gluteal region following a history of an intramuscular injection in the right gluteal region. Clinical examination suggested morphea, prompting us to conduct an MRI to better understand the extent and nature of her condition. The MRI results revealed thickening of the skin layers and signs of inflammation, helping us differentiate between active inflammation and fibrosis. This case illustrates how MRI can provide crucial insights for managing morphea effectively.

Contradictory Recommendation in the Guideline for Antibiotic Prescription.

How to cite this article: Das PK, Nath SS, Parashar S. Contradictory Recommendation in the Guideline for Antibiotic Prescription. Indian J Crit Care Med 2024;28(7):713-714.

In Vitro Morphogenesis of Tobacco: Modulation of Endogenous Growth Regulators by Tulsi (Holy Basil).

Plant growth regulators (PGRs) play a vital role in the induction of morphogenesis in vitro. Synthetic PGRs are commonly used to induce organogenesis and somatic embryogenesis from various explants, while natural substances are rarely utilized. This study aimed to enhance the regenerative response in Nicotiana tabacum leaf explants using Tulsi (Ocimum sanctum) leaf extract and to elucidate the biochemical interactions during modulation of endogenous plant growth regulators, including indole-3-acetic acid (IAA), abscisic acid (ABA), zeatin, and 6-(γ, γ-dimethylallylamino) purine (2iP). Tulsi leaf extract significantly improved shoot production through interactions between endogenous hormones and those present in the extract, which enhanced stress mitigation. The 20% Tulsi leaf extract treatment produced significantly more shoots than the control, coinciding with increased endogenous IAA and zeatin levels starting on day 10 in culture. Furthermore, ABA and zeatin concentrations increased on days 15 and 25, respectively, in the 20% Tulsi extract treatment, suggesting their role in the induction of somatic embryo-like structures. ABA likely acts as an activator of stress responses, encouraging the development of these structures. Additionally, 2iP was involved in the induction of both forms of regeneration in the 10% and 20% extract treatments, especially in combination with ABA. These results suggest that Tulsi leaf extract holds promising potential as a natural supplement for increasing plant regeneration in vitro and advancing our understanding of how natural extracts of plant origin can be harnessed to optimize plant regeneration processes in vitro.

Enhanced photocatalytic performance of Bi-doped TiO2 under sunlight and UV light: mechanistic insights and comparative analysis.

Bismuth-doped metal oxides exhibit favourable photocatalytic features when exposed to both sunlight and UV light. In this approach, Bi0/TiO2 and Bi+3/TiO2 photocatalysts were prepared and their structural and optical properties are analysed using various characterization techniques. These developed photocatalysts were further tested for the photocatalytic elimination of Nitrobenzene in UV light and sunlight and compared with the performance of bare TiO2. The catalyst Bi+3/TiO2 performed better in UV light with 72.31% degradation, and 4.74 × 10-6 mol.litre-1.min-1 initial rate of reaction. However, when exposed to sunlight, Bi0/TiO2 outperformed with 73.85% degradation, and 4.63 × 10-6 mol.min-1 initial rate of reaction. This significant increase in photocatalytic activity of Bi0/TiO2 under sunlight could be accredited to increased light harvesting and enhanced efficiency in charge carrier separation, both of which were made possible by bismuth-induced surface plasmon resonance.

Effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion: a randomized, single-blind study.

Although low-flow anesthesia is widely used due to its various advantages, there are concerns about potential and relative hypoxia. Furthermore, oxygen is also a drug with benefits and adverse effects. We aimed to evaluate and compare the effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion and to compare the economic benefits. With ethical approvals and informed consent, participants were randomly assigned to a dynamic group (13 males, and 27 females) receiving fresh gas flows depending on real-time oxygen consumption (dynamic O2: N2O), and a fixed group (20 males, and 13 females) receiving fixed fresh gas flows of 600 mL/min (with O2: N2O of 1:1). Oxygen partial pressure and serum lactate were comparable between groups. However, isoflurane consumed and costs incurred were significantly different. Total oxygen consumption per minute was also significantly lower in the dynamic group than the fixed group. No episodes of hypoxia were observed in either group. Real-time oxygen consumption-based low flow anesthesia is feasible and cost-effective without affecting the patient's global perfusion and outcome.

Enhancing Preoperative Assessment of Endometrial Cancer: The Role of Diffusion-Weighted Magnetic Resonance Imaging in Evaluating Myometrial Invasion.

BACKGROUND: Endometrial cancer (EC) is the most common gynecological malignancy. Accurate preoperative staging is essential for guiding treatment. The depth of myometrial invasion is a key prognostic factor. This prospective study aimed to evaluate the added benefit of diffusion-weighted imaging (DWI) compared to T2-weighted imaging (T2WI) and dynamic contrast-enhanced MRI (DCE-MRI) for the preoperative assessment of myometrial invasion in EC. AIM AND OBJECTIVES: The aim of this prospective study was to evaluate the added benefit of DWI in the preoperative assessment of myometrial invasion in EC, in comparison with T2WI and DCE-MRI. The objectives were to assess the imaging characteristics of endometrial carcinoma on T2WI, DCE, and DW MR, to assess the depth of myometrial invasion and overall stage in EC patients, to compare the diagnostic performance of DCE-MRI with that of DW-MRI combined with T2WI, to describe how MR imaging findings can be combined with tumor histologic features and grading to guide treatment planning, and to evaluate the pitfalls and limitations of DCE and DW MR in the assessment of EC. MATERIALS AND METHODS: Thirty-one patients with histologically confirmed EC underwent preoperative pelvic MRI on a 1.5T scanner. T2WI, DWI (b-values 0, 1000 s/mm2), and DCE-MRI were performed. Two radiologists independently assessed myometrial invasion on T2WI, T2WI + DWI, and T2WI + DCE-MRI. Histopathology after hysterectomy was the reference standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each MRI protocol, with separate analyses for superficial (<50%) and deep (≥50%) myometrial invasions. RESULTS: The accuracy for assessing superficial invasion was 61.3% for T2WI, 87.1% for T2WI + DWI, and 87.1% for T2WI + DCE-MRI. For deep invasion, accuracy was 64.5% for T2WI, 90.3% for T2WI + DWI, and 90.3% for T2WI + DCE-MRI. Sensitivity, specificity, PPV, and NPV for T2WI + DWI and T2WI + DCE-MRI were high and comparable (88.9-91.7%) for both superficial and deep invasions. T2WI had markedly lower sensitivity and specificity. The differences between T2WI and the functional MRI protocols were statistically significant (p < 0.01). CONCLUSION: DWI and DCE-MRI significantly improve the diagnostic performance of MRI for the preoperative assessment of myometrial invasion depth in EC compared to T2WI alone. DWI + T2WI and DCE-MRI + T2WI demonstrate comparable high accuracy. DWI may be preferable since it is faster and avoids contrast administration.