Preoperative Evaluation of Myometrial Invasion in Endometrial Carcinoma: Prospective Intra-individual Comparison of Magnetic Resonance Volumetry, Diffusion-weighted and Dynamic Contrast-enhanced Magnetic Resonance Imaging.

AIM: The purpose of this prospective study was to compare the diagnostic performance of diffusion-weighted (DWI) and dynamic contrast-enhanced imaging (DCE) and volumetric analyses in the preoperative assessment of myometrial invasion in patients with endometrial carcinoma. MATERIALS AND METHODS: Thirty-five patients with endometrial cancer underwent preoperative magnetic resonance imaging including DWI and DCE for evaluation of the depth of myometrial invasion and volumetric analyses [tumor volume (TV), uterine volume (UV), tumor to volume ratio (TVR=(TV/TU)×100)]. The results of the evaluations were compared to the histopathological examinations. RESULTS: DWI and DCE showed a sensitivity and specificity in evaluating the depth of myometrial invasion of 92% and 96% and 92% and 86%, respectively, while volumetric analyses showed a sensitivity and specificity of 85% and 86% (TVR cut-off=10%) and 69% and 100% (TVR cut-off=25%), respectively. CONCLUSION: DWI and DCE are both good diagnostic tools for the preoperative assessment of myometrial invasion. From our results and literature research, there is potential for omitting gadolinium-based contrast agents given the high diagnostic value of DWI. In our patient collective, the predictive power of volumetric analyses was lower than that of DWI.

MRI as a tool for non-invasive vascular profiling: a pilot study in patients with aortic coarctation.

AIM: While the overall concept of aortic coarctation has changed from one of simple obstruction to one that includes significant vascular dysfunction, this has not yet been translated into the diagnostic and treatment process. To close this gap, we sought to demonstrate the usefulness of an additional non-invasive vascular profile. METHOD: During a pilot study in eight coarctation patients, aortic area compliance, aortic distensibility, time phase shift and blood flow (distribution) were calculated from cine-MRI and 2D-/4D-velocity-encoded MRI sequences. RESULTS: Compared to healthy individuals, a significantly lower aortic compliance and reduced flow to the descending aorta were found in patients with coarctation. DISCUSSION: These differences underline the potential usefulness of a combined vascular profile in coarctation patients. CONCLUSION: It was successfully shown that functional vascular profiling of the aorta is feasible to be acquired non-invasively in a clinical setting and can provide additional diagnostic information. These can be the key input parameters for computational fluid dynamics-modeling.