Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

Abstract

Our purpose is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC) measurement in differentiating malignant from benign uterine endometrial cavity lesions. We retrospectively evaluated 25 uterine endometrial cavity lesions in 25 female patients: endometrial carcinoma (n = 11), carcinosarcoma (n = 2), submucosal leiomyoma (n = 8), and endometrial polyp (n = 4). Diffusion-weighted images were performed at 1.5 T with b factors of 0-1,000/mm(2). The region of interest was defined within the tumor on T2-weighted EPI image and then manually copied to an ADC map. Thereby, the ADC value was obtained. We compared ADC values between malignant and benign lesions using Student's t-test. The mean and standard deviation of ADC values (x10(-3) mm(2)/s) were as follows: endometrial carcinoma, 0.98+/-0.21; carcinosarcoma, 0.97+/-0.02; submucosal leiomyoma, 1.37+/-0.28; and endometrial polyp, 1.58+/-0.45. The ADC values differed significantly between malignant (0.98+/-0.19) and benign lesions (1.44+/-0.34) (P < 0.01). We defined malignant tumors as cases with an ADC value less than 1.15 x 10(-3) mm(2)/s for obtaining the highest accuracy. Sensitivity, specificity, and accuracy were 84.6%, 100%, and 92%, respectively. ADC measurement can provide useful information in differentiating malignant from benign uterine endometrial cavity lesions.

Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results

“…The use of these sequences may produce image distortion caused by susceptibility artifacts, due to the presence of air and chemical shift artifacts from fatty tissue. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] These artifacts were not seen in the present study, probably because of the lack of neighboring organs in the scrotal area. A relatively low signal to noise ratio and spatial resolution has also been reported with these images.…”

“…Another advantage of echo planar sequences is rapid image acquisition, reducing motion artifacts. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] There were some limitations in this study. First, it was a retrospective review of a small number of patients with a narrow range of scrotal abnormalities.…”

“…In agreement with previous study, this study reported reduced ADC values for malignancies. [12][13][14][15][16][17][18][19][20][21][22][23] The decrease of ADC values in testicular neoplasms is related to the histopathological characteristics of neoplastic tissue, that is, increased tissue cellularity, densely packed malignant cells, enlargement of the nuclei, and angulation of the nuclear contour, all causing reduced motility of water molecules.…”

“…Axial fat-suppressed T1-weighted sequences were repeated when a lesion with high T1 signal intensity was noted. DW imaging was performed along the axial plane, using a single shot, multislice spin echo planar diffusion pulse sequence and b values of 0 and 900 s mm 22 . The orientation and location of these images were identical to the conventional transverse sequences.…”

“…The ADC values of malignancies are reported lower than those of benign lesions or normal tissues. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Published series reported the usefulness of DW MR imaging in the early detection of ischemia in the testis of Wistar rats and in the detection of nonpalpable testes in children. 24,25 To the author's knowledge, there are no reports in the English-language literature, regarding the normal ADC values of the scrotal contents, that is the testis and the epididymis and the ADC values of scrotal pathology.…”