Diffusion-Weighted Single-Shot Echo-Planar Imaging with Parallel Technique in Assessment of Endometrial Cancer

Shen, Shu-Huei; Chiou, Yi–You; Wang, Jia-Hwia; Yen, Ming‐Shyen; Lee, Rheun‐Chuan; Lai, Chiung‐Ru; Chang, Cheng-Yen

doi:10.2214/ajr.07.2155

Cited by 147 publications

(108 citation statements)

References 16 publications

(23 reference statements)

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“…Other studies have also evaluated the accuracy of DW-MRI in assessment of myometrial invasion [20][21][22] and have shown similar results. Shen at al.…”

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confidence: 65%

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Advances in magnetic resonance imaging of endometrial cancer

Sala

Rockall

2010

Eur Radiol

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Endometrial cancer is the most commonly diagnosed gynaecological malignancy in affluent societies [1]. It occurs most frequently in white women, with peak incidence between ages 55 and 65. Risk factors include unopposed oestrogen intake, use of tamoxifen, nulliparity, obesity, and diabetes. The incidence of endometrial cancer in the United Kingdom has increased by more than 40% between 1993 and 2007. This significant rise is predominantly due to a large increase in incidence in women aged 60-79 [1]. These trends are very similar for most European countries [2]. The increase in prevalence of obesity and decreases in fertility may partly account for the observed rapid increase in incidence and imply that endometrial cancer in postmenopausal women will become a more substantial public health problem in the future.Prognosis depends on a number of factors, including stage, depth of myometrial invasion, lymphovascular invasion, nodal status and histological grade. Depth of myometrial invasion is the single most important morphologic prognostic factor, correlating with tumour grade, lymph node metastases and overall patient survival. Incidence of lymph node metastases increases from 3% with superficial myometrial invasion (stage IA) to 46% with deep myometrial invasion (stage IB) [3]. Preoperative knowledge of these factors is crucial in tailoring the surgical approach. The histological grade can be determined at endometrial sampling, whereas depth of myometrial invasion can only be assessed preoperatively by MRI. Therefore, MRI can assist in preoperative assessment and treatment planning by accurately predicting depth of myometrial invasion, cervical stromal invasion and lymph node involvement. This information allows selection of patients for pelvic or para-aortic lymph node sampling whilst obviating the need for surgery in patients with low risk disease. MRI can also provide additional useful information such as uterine size, tumour volume, ascites and adnexal pathology which in turn may determine whether the surgical approach is transabdominal, transvaginal or laparoscopic.Lymphadenectomy in early (stage I) endometrial cancer remains a controversial issue. Two large prospective multicentre studies investigated whether pelvic lymphadenectomy could improve survival of women with endometrial cancer [4,5]. Both studies reported no benefit in overall or recurrence free survival in the patients randomized to lymphadenectomy. Conversely, the SEPAL study [6] showed that in patients with intermediate or high risk of endometrial cancer recurrence, combined pelvic and paraaortic lymphadenectomy reduced the risk of death compared with pelvic lymphadenectomy alone. The authors acknowledged that MRI is an important factor for predicting lymph node metastasis, and in combination with tumour grade and histology could be helpful to discriminate patients with very low risk of recurrence. Therefore,

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“…Other studies have also evaluated the accuracy of DW-MRI in assessment of myometrial invasion [20][21][22] and have shown similar results. Shen at al.…”

mentioning

confidence: 65%

“…Shen at al. [20] compared the use of DW-MRI and DCE-MRI in the evaluation of depth of myometrial invasion and found that the diagnostic accuracy was 62% for DW-MRI compared to 71% for DCE-MRI. However, both DW-MRI and DCE-MRI images were acquired in the sagittal plane only.…”

mentioning

confidence: 99%

Advances in magnetic resonance imaging of endometrial cancer

Sala

Rockall

2010

Eur Radiol

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“…DWI imaging of endometrial tumors has decreased ADC values (108)(109)(110)(111)(112)(113)(114)(115)(116). Endometrial carcinoma is clearly depicted as an area of increased signal intensity relative to the surrounding hypointense myometrium on DWI (116).…”

Section: Female Pelvis Applicationsmentioning

confidence: 99%

“…Endometrial carcinoma is clearly depicted as an area of increased signal intensity relative to the surrounding hypointense myometrium on DWI (116). ADC measurements have the potential to quantitatively differentiate Stage IA endometrial carcinoma from normal endometrium, endometrial dysplasia and benign diseases of the endometrium, such as endometrial hyperplasia, adenomyosis, submucosal leiomyoma, and endometrial polyps (108)(109)(110)(111)(112)(113)(114)(115)(116). DWI and combined DWI/T2W MRI can increase the overall detection sensitivity for endometrial carcinoma (113).…”

Section: Female Pelvis Applicationsmentioning

confidence: 99%

“…DWI and combined DWI/T2W MRI can increase the overall detection sensitivity for endometrial carcinoma (113). Although lower ADC values in high-grade tumors have been reported, some studies have reported no correlation between ADC values and histological grades (115,116). DWI is accurate for differentiating stage IB from stage IC and can be used as an adjunct for routine T2W MRI during pre-operative evaluation of endometrial cancer (111,117).…”

Section: Female Pelvis Applicationsmentioning

confidence: 99%

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Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Türkbey

Aras

Karabulut

et al. 2011

Diagn Interv Radiol

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Imaging is used to detect, characterize, and monitor cancer. Recently, diffusion-weighted magnetic resonance imaging (DWI) has become a useful adjunct for assessing tumors with magnetic resonance imaging (MRI). DWI involves the acquisition of a magnetic resonance signal related to random thermal motion (Brownian motion) or the "diffusion" of water protons in tissue. The signal obtained with DWI is a measure of the net displacement of water molecules, e.g., the water path length in the extracellular, intracellular and intravascular spaces. This motion is largely random and can be reduced by structural barriers, such as cell membranes and collagen. Restricted diffusion in biological tissues is inversely proportional to tissue cellularity and the integrity of cell membranes, and it can be quantified with apparent diffusion coefficient (ADC) measurements (1). Depending on the microarchitecture, either restricted or increased diffusion can occur in malignant tumors. For instance, diffusion is restricted in cellular portions of the tumor, but it may be increased in necrotic portions (2, 3). Other causes of enhanced diffusion include increased water content arising from intratumoral edema and cystic tumor components (4-6).Although initially used to evaluate neurological diseases, the applications of DWI have been extended to oncologic imaging throughout the body made possible by improvements in MRI hardware and new sequences. The use of DWI as a complement to conventional MRI methods has led to improvements in the detection and characterization of tumors, treatment response monitoring, and detection of recurrence in oncology patients. Basic concepts of DWIIn 1965, Stejskal and Tanner (7) proposed the application of a symmetric pair of additional gradients on either side of the 180˚ refocusing radiofrequency pulse. The Stejskal-Tanner sequence is still the basis of modern DWI. For static water molecules, the phasing effect caused by the first gradient will be reversed by the second gradient, leading to no signal loss; however, this phasing effect will not be completely reversed if the water molecules are not stationary, which results in the observed well-known diffusion signal decay. The amount of diffusion weighting is determined by the b value, which describes the amplitude, duration of the applied gradient, and time interval between the two diffusion gradients (4). The degree of signal attenuation from water molecules is cor- ABSTRACT Diffusion-weighted magnetic resonance imaging (MRI), which involves the acquisition of a magnetic resonance signal related to the Brownian motion of water protons in tissue, has become a useful technique for assessing tumors. In this article, we review the basic concepts, imaging strategies, and body applications of diffusion-weighted MRI in detecting and monitoring cancer.

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Cytology for the diagnosis of endometrial cancer in symptomatic women

O’Flynn

Jones

Njoku

et al. 2021

Cochrane Database of Systematic Reviews

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We will present the cytology preparation method of each study in a separate table so this information can be cross-referenced when interpreting results. The types of cytology preparations are likely to include:• direct spreads -sample centrifuged to produce a pellet which is spread directly onto a glass slide and stained;Cytology for the diagnosis of endometrial cancer in symptomatic women (Protocol)

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Diffusion-Weighted Single-Shot Echo-Planar Imaging with Parallel Technique in Assessment of Endometrial Cancer

Cited by 147 publications

References 16 publications

Advances in magnetic resonance imaging of endometrial cancer

Advances in magnetic resonance imaging of endometrial cancer

Diffusion weighted MRI for detecting and monitoring cancer: a review of current applications in body imaging

Cytology for the diagnosis of endometrial cancer in symptomatic women

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