Diffusion Weighted Imaging in the Assessment of Tumor Grade in Endometrial Cancer Based on Intravoxel Incoherent Motion MRI

Chryssou, Evangelia; Manikis, Georgios C.; Ioannidis, Georgios; Chaniotis, Vrettos; Vrekoussis, Thomas; Maris, Thomas G.; Marias, Kostas; Karantanas, Apostolos H.

doi:10.3390/diagnostics12030692

Cited by 6 publications

(3 citation statements)

References 38 publications

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“…Important prognostic factors for EC are the histological subtype of tumor, histological grade, stage, the depth of myometrial invasion and the presence of lymphovascular invasion, among which the stage and histological grade correlate with the risk of lymph node metastasis and the patient's prognosis (33)(34)(35). EC with a low histological grade has a lower cell density and greater movement of water molecules in the matrix and therefore tends to have higher ADC values.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

et al. 2023

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IntroductionMagnetic resonance imaging (MRI) with its innovative techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), increases the diagnostic accuracy in distinguishing between malignant and benign lesions of the endometrium. The aim of the study was MRI differentiation between malignant and benign endometrial lesions and correlation with histopathological findings with a special emphasis on quantitative analysis. An additional aim was to correlate the ADC values and histological tumor grades.MethodsThe prospective study included 119 female patients with or without vaginal bleeding and pathological values of endometrial thickness, who underwent MRI examinations. According to MRI reports the patients were divided into 45 suspicious malignant and 74 suspicious benign endometrial lesions. The radiological diagnosis was compared to the histopathological evaluation, which confirmed 37 malignant lesions while the rest were benign.ResultsThe mean ADC value for malignant lesions was 0.761 ± 0.13×10−3 mm2/s and for benign lesions was 1.318 ± 0.20×10−3 mm2/s. The ADC values for malignant lesions were expectedly lower than those of benign lesions (p<0.001). The ADC cut-off value was 1.007×10−3 mm2/s with a sensitivity of 100%, specificity of 92.7%, a positive predictive value of 60.3%, and a negative predictive value of 100%. In comparison with the histopathological findings, the sensitivity of MRI was 100%, specificity 90.2%, positive predictive value was 82.2%, and negative predictive value was 100%. Observing the histological grades 1, 2, and 3 of endometrial carcinoma, no statistically significant differences of mean ADC values were found. The mean ADC values for histological tumor grades 1,2 and 3 were 0.803 ± 0.13×10−3 mm2/s, 0.754 ± 0.12×10−3 mm2/s and 0.728 ± 0.13×10−3 mm2/s, respectively.ConclusionDWI and ADC values represent clinically useful tools for the differentiation between malignant and benign endometrial lesions with high sensitivity and good specificity, but the results failed to demonstrate their usefulness in differentiating histological grades of endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

et al. 2023

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“…Чувствительность данного признака в дифференциальной диагностике ВЛС от ДЛС составила 87,5 %, специфичность -70 %. Магнитно-резонансная томография (МРТ) в сочетании с методикой диффузионно-взвешенной МРТ (ДВ-МРТ) в настоящее время является одним из наиболее перспективных методов, позволяющим с высокой точностью судить о внутреннем строении опухоли и, по мнению ряда авторов, косвенно оценивать ее морфологическую структуру [17][18][19][20][21][22][23].…”

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Possibilities of Diffusion-Weighted MRI in Clarification of the Degree of Malignance of Recurrent Retroperitoneal Liposarcomas

Колобанова¹,

Медведева²,

Лаптева³

2022

jour

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The aim of our study was to study the possibilities of DW-MRI in the differential diagnosis of recurrent retroperitoneal highly differentiated and dedifferentiated liposarcomas (WLS and DLS respectively).Material and methods: The study is based on the data of a retrospective study of 36 patients who underwent surgery on for retroperitoneal highly differentiated (n = 27) and dedifferentiated liposarcomas (n = 9). All patients received MRI of the abdominal cavity and pelvis without intravenous contrast enhancement with further assessment of size, shape, contours and structure. When analyzing DW-MRI and ADC maps, small soft tissue nodes were evaluated.Results: Morphological studies were performed in all patients. The results of the qualitative analysis showed statistically significant differences in the differential diagnosis of WLS recurrences from DPS in the presence of septa and pseudocapsule (p = 0.0032 and p = 0.0028, respectively). The results of the study demonstrated differences in the ADC values in the solid component of recurrent tumors of WLS and DLS: the median ADC values in the WLS group were higher (1960×10 -6 mm 2 /s) than in the DLS group (1031×10 -6 mm 2 /s). The sensitivity of this sign in the differential diagnosis of WLS from DLS was 87.5 %, the specificity was 70 %.

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“…Intravoxel incoherent motion includes bi-exponential and stretched-exponential models and is used to reflect capillary microcirculatory perfusion, while DKI describes tissue heterogeneity. The IVIM model was previously found to be related to pathological indicators and useful for the disease grading of EC (Ma et al 2023 ; Satta et al 2021 ; Chryssou et al 2022 ); it also showed higher efficacy than ADC in differentiating an endometrial malignancy from the normal endometrium (Liu et al 2016 ). Diffusion kurtosis imaging is based on the non-Gaussian model and has a high sensitivity for reflecting the complexity of the tissue microstructure (Jensen et al 2005 ).…”

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confidence: 99%

A comparative study of mono-exponential and advanced diffusion-weighted imaging in differentiating stage IA endometrial carcinoma from benign endometrial lesions

Li,

Cao,

et al. 2024

J Cancer Res Clin Oncol

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Purpose The purpose of the current investigation is to compare the efficacy of different diffusion models and diffusion kurtosis imaging (DKI) in differentiating stage IA endometrial carcinoma (IAEC) from benign endometrial lesions (BELs). Methods Patients with IAEC, endometrial hyperplasia (EH), or a thickened endometrium confirmed between May 2016 and August 2022 were retrospectively enrolled. All of the patients underwent a preoperative pelvic magnetic resonance imaging (MRI) examination. The apparent diffusion coefficient (ADC) from the mono-exponential model, pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) from the bi-exponential model, distributed diffusion coefficient (DDC), water molecular diffusion heterogeneity index from the stretched-exponential model, diffusion coefficient (Dk) and diffusion kurtosis (K) from the DKI model were calculated. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficiency. Results A total of 90 patients with IAEC and 91 patients with BELs were enrolled. The values of ADC, D, DDC and Dk were significantly lower and D* and K were significantly higher in cases of IAEC (p < 0.05). Multivariate analysis showed that K was the only predictor. The area under the ROC curve of K was 0.864, significantly higher compared with the ADC (0.601), D (0.811), D* (0.638), DDC (0.743) and Dk (0.675). The sensitivity, specificity and accuracy of K were 78.89%, 85.71% and 80.66%, respectively. Conclusion Advanced diffusion-weighted imaging models have good performance for differentiating IAEC from EH and endometrial thickening. Among all of the diffusion parameters, K showed the best performance and was the only independent predictor. Diffusion kurtosis imaging was defined as the most valuable model in the current context.

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Diffusion Weighted Imaging in the Assessment of Tumor Grade in Endometrial Cancer Based on Intravoxel Incoherent Motion MRI

Cited by 6 publications

References 38 publications

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

Possibilities of Diffusion-Weighted MRI in Clarification of the Degree of Malignance of Recurrent Retroperitoneal Liposarcomas

A comparative study of mono-exponential and advanced diffusion-weighted imaging in differentiating stage IA endometrial carcinoma from benign endometrial lesions

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