Diffusion volume (DV) measurement in endometrial and cervical cancer: A new MRI parameter in the evaluation of the tumor grading and the risk classification

Mainenti, Pier Paolo; Pizzuti, Laura; Segreto, Sabrina; Comerci, Marco; Fronzo, Simona De; Romano, Federica; Crisci, Vincenzina; Smaldone, Michele; Laccetti, Ettore; Storto, Giovanni; Alfano, Bruno; Maurea, Simone; Salvatore, Marco; Pace, Leonardo

doi:10.1016/j.ejrad.2015.10.014

Cited by 32 publications

(14 citation statements)

References 35 publications

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“…Type II EC tumors were found to be bigger than type I, which was in line with previous studies (18,19) that have linked tumor volume to its grade and burden. These results are considered to be due to the expansive mode of growth of the high-grade EC.…”

Section: Discussionsupporting

confidence: 92%

The value of the apparent diffusion coefficient in differentiating type II from type I endometrial carcinoma

Chen

Fan

et al. 2020

Acta Radiol

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Background Diagnostic type II endometrial carcinoma (EC) is considered more aggressive and has a poorer prognosis than type I EC; differentiation between them is helpful for preoperative clinical decision-making. However, the diagnostic value of the apparent diffusion coefficient (ADC) in differentiating them remains unclear. Purpose To investigate the value of ADC in differentiating type II EC from type I EC. Material and Methods Ninety-four patients with EC who underwent diffusion-weighted imaging (DWI) were retrospectively included and divided into type I and type II subgroups, based on the postoperative pathologic results. We analyzed the clinical characteristics, conventional magnetic resonance imaging manifestations, and ADC mean values (ADCmean), ADC minimum values (ADCmin), and ADC max values (ADCmax). Receiver operating characteristic (ROC) curve analysis was further used to assess the predictive performance. Results The ADCmean, ADCmin, and tumor size differed significantly between the two subtypes. The area under the ROC curve (AUC) for ADCmean and ADCmin was 0.787 (95% confidence interval [CI] = 0.692–0.88) and 0.835 (95% CI = 0.751–0.919) for predicting type II EC, respectively. The optimal cut-off value of ADCmean for prediction was 0.757 × 10–3 mm2/s with a sensitivity of 91%, a specificity of 58%, and an accuracy of 74%, while for ADCmin was 0.637 × 10–3 mm2/s with a sensitivity of 82%, a specificity of 73%, and an accuracy of 75%. Conclusion EC with lower ADCmean and ADCmin values derived from DWI, and a larger size, are indicative of type II EC.

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Section: Discussionsupporting

confidence: 92%

The value of the apparent diffusion coefficient in differentiating type II from type I endometrial carcinoma

Chen

Fan

et al. 2020

Acta Radiol

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“…Polypoid growth pattern into the endometrial cavity in large stage IA tumors might have caused high TVR values, and infiltrative pattern in small stage IB tumors might have caused low TVR values, overall creating overlaps. Moreover, both tumor size and tumor volume were not predictors of negative prognostic factors (deep myometrial invasion, high tumor grade, LVSI, or nonendometrioid type histology) in our study, as opposed to previous studies 8,9,15,16,27. Mean tumor volume in our study was close to results of study of Nougaret et al 15 (14 cm 3 vs 19.9 cm 3 in T2 weighted sagittal images).…”

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confidence: 75%

“…In another study focusing on diffusion weighted MR imaging of endometrial cancer, diffusion volume of the tumor was shown to be an accurate index for the assessment of grade and risk classification. 16 However, the reproducibility of tumor volume based on MR volumetry in regard to clinical significance has not been validated in different cohorts from different countries.…”

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confidence: 99%

Preoperative Magnetic Resonance Volumetry in Predicting Myometrial Invasion, Lymphovascular Space Invasion, and Tumor Grade: Is It Valuable in International Federation of Gynecology and Obstetrics Stage I Endometrial Cancer?

Şahin

Sarıoğlu

Bağci

et al. 2018

Int J Gynecol Cancer

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“…The ADC has value in differentiating between normal uterine cervix stroma and cervical carcinoma [ 79 – 87 ]. Furthermore, the ADC shows potential for assessing pathological subtypes and for tumour grade differentiation [ 14 , 60 , 88 – 92 ]. A recent study [ 93 ] reported lower ADC values in poorly differentiated tumours compared to well/moderately differentiated tumours ( p = 0.02).…”

Section: Grading and Subtype Differentiationmentioning

confidence: 99%

The value of advanced MRI techniques in the assessment of cervical cancer: a review

et al. 2017

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ObjectivesTo assess the value of new magnetic resonance imaging (MRI) techniques in cervical cancer.MethodsWe searched PubMed and MEDLINE and reviewed articles published from 1990 to 2016 to identify studies that used MRI techniques, such as diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and dynamic contrast enhancement (DCE) MRI, to assess parametric invasion, to detect lymph node metastases, tumour subtype and grading, and to detect and predict tumour recurrence.ResultsSeventy-nine studies were included. The additional use of DWI improved the accuracy and sensitivity of the evaluation of parametrial extension. Most studies reported improved detection of nodal metastases. Functional MRI techniques have the potential to assess tumour subtypes and tumour grade differentiation, and they showed additional value in detecting and predicting treatment response. Limitations included a lack of technical standardisation, which limits reproducibility.ConclusionsNew advanced MRI techniques allow improved analysis of tumour biology and the tumour microenvironment. They can improve TNM staging and show promise for tumour classification and for assessing the risk of tumour recurrence. They may be helpful for developing optimised and personalised therapy for patients with cervical cancer.Teaching points • Conventional MRI plays a key role in the evaluation of cervical cancer. • DWI improves tumour delineation and detection of nodal metastases in cervical cancer. • Advanced MRI techniques show promise regarding histological grading and subtype differentiation. • Tumour ADC is a potential biomarker for response to treatment.

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Diffusion volume (DV) measurement in endometrial and cervical cancer: A new MRI parameter in the evaluation of the tumor grading and the risk classification

Cited by 32 publications

References 35 publications

The value of the apparent diffusion coefficient in differentiating type II from type I endometrial carcinoma

The value of the apparent diffusion coefficient in differentiating type II from type I endometrial carcinoma

Preoperative Magnetic Resonance Volumetry in Predicting Myometrial Invasion, Lymphovascular Space Invasion, and Tumor Grade: Is It Valuable in International Federation of Gynecology and Obstetrics Stage I Endometrial Cancer?

The value of advanced MRI techniques in the assessment of cervical cancer: a review

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