MR imaging of endometrial carcinoma for preoperative staging at 3.0 T: Comparison with imaging at 1.5 T

Abstract

Purpose:To prospectively compare magnetic resonance imaging (MRI) at 3.0 T and 1.5 T in the same patients for preoperative evaluation of endometrial carcinoma. Materials and Methods:Thirty consecutive patients with endometrial carcinoma underwent MRI at both 3.0 T and 1.5 T as well as surgery. Quantitative and qualitative analyses were performed. Two radiologists independently evaluated images. MR findings were compared with surgicopathologic findings.Results: Image homogeneity of T2-weighted images at 3.0 T was significantly inferior to that at 1.5 T (P ϭ 0.007). The scores of image homogeneity and susceptibility artifacts were not significantly different between 3.0 T gadoliniumenhanced imaging and 1.5 T imaging (P ϭ 0.09 and 0.36). Kappa statistics showed good interobserver agreement between the two radiologists for local-regional staging on T2-weighted images ( Ͼ0.6). The area under the receiver operating characteristic curve (Az) values for T2-weighted imaging in terms of myometrial invasion, cervical invasion, and lymph node metastases were 0.88 (3.0 T) versus 0.91 (1.5 T), 0.84 versus 0.83, and 0.94 versus 0.95 for reader 1, respectively. There were no significant differences between imaging at 3.0 T and at 1.5 T in Az values for either reader (P Ͼ 0.35).Conclusion: 3.0 T MRI is an equivalent imaging modality to 1.5 T imaging for presurgical evaluation of endometrial carcinoma, although not significantly superior to 1.5 T imaging.

Standard 1.5-T MRI of endometrial carcinomas: modest agreement between radiologists

“…Three previous studies on interobserver variation in the preoperative MRI staging of endometrial carcinomas included only two observers [16][17][18]. Hori et al [16] reported good interobserver agreement on T2-weighted imaging for deep myometrial invasion (κ00.66/0.67 at 3.0 T and 1.5 T, respectively), cervical stroma invasion (κ00.77/0.76), and lymph node metastases (κ00.64/0.74).…”

“…Among the numerous papers published in the last few decades on MRI in endometrial carcinomas [15], few reports presented data on interobserver agreement, and then only for two observers [16][17][18][19][20][21]. The aims of this study were to evaluate the degree of agreement between several radiologists on pelvic MRI findings of deep myometrial invasion, cervical stroma invasion and lymph node metastases in endometrial carcinomas, and to compare these imaging findings with results from surgical staging.…”

Diagnostic possibility of diffusion tensor imaging for the evaluation of myometrial invasion in endometrial cancer: An ex vivo study

“…The imaging characteristics of myometrial invasion include disruption of the junctional zone observed by T2-weighted imaging (T2WI) or discontinuity on early subendometrial contrast enhancement by dynamic contrast-enhanced imaging (DCE) (2). The accuracy of detecting myometrial invasion by endometrial cancer using T2-weighted images varies between 77% and 87% (3)(4)(5), whereas that using DCE is about 89%-91% (4,(6)(7)(8)(9). Recent reports suggest that the diagnostic accuracy of a combination of diffusionweighted imaging (DWI), T2WI, and DCE is more than that of imaging without DWI (10)(11)(12).…”

Ovarian Masses: MR Imaging with T1-weighted 3-dimensional Gradient-echo IDEAL Water-fat Separation Sequence at 3T

“…33 This could be important with the increased use of 3T MR systems over the past several years to image a variety of areas, including the fe- male pelvis. [34][35][36][37] However, acquisition time can be shorter with the dual-echo Dixon than the IDEAL technique, which requires 3 echoes, and thereby yield fewer motion artifacts. We think a comparison of pelvic imaging between the 2 techniques is needed.…”