Endometrial cancer with cervical stromal invasion: diagnostic accuracy of diffusion-weighted and dynamic contrast enhanced MR imaging at 3T.
Eur Radiol
; 27(5): 1867-1876, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-27631107
ABSTRACT
OBJECTIVES:
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.METHODS:
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.RESULTS:
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).CONCLUSIONS:
DW MR imaging has superior diagnostic performance compared with DCE MR imaging in the detection of cervical stromal invasion. KEY POINTS ⢠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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Uterinas
/
Neoplasias do Endométrio
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article