MR volumetry in predicting the aggressiveness of endometrioid adenocarcinoma: correlation with final pathological results

Abstract

Background Magnetic resonance (MR) has been widely used in predicting the aggressiveness of endometrioid adenocarcinoma. However, the diagnostic value of the MR volume of the lesion has been controversial. Purpose To determine whether the whole-lesion MR volume measurement could be used as a better predictor for evaluating the aggressiveness of endometrioid adenocarcinoma. Material and Methods In this retrospective study, we include 357 patients with pathologically demonstrated endometrioid adenocarcinoma at our institution between 1 January 2013 and 31 December 2018. Whole-lesion MR volume was calculated on sagittal T2-weighted images with ITK-SNAP software on a personal computer. Results According to the receiver operating characteristics curve analysis, whole-lesion MR volume has the competitive advantage in evaluating deep myometrial invasion compared with the frozen results, generating area under the curve (AUC) values of 0.751 vs. 0.834 ( P = 0.0629, Z = 1.860). The AUC of tumor maximum diameter, simple tumor volume, and whole-lesion MR volume in predicting deep myometrial invasion was 63.8%, 67.6%, and 75.1%, respectively. Conclusion Whole-lesion MR volume is a good diagnostic tool for prediction of deep myometrial invasion, lymph node metastasis, and lymphovascular invasion. MR volumetry could reflect the aggressiveness of endometrioid adenocarcinoma more accurately than traditional lesion measurements.

Whole‐tumor apparent diffusion coefficient histogram analysis for preoperative risk stratification in endometrial endometrioid adenocarcinoma

“…Similarly, Chen et al 23 . and Cai et al 24 . reported that the maximal tumor diameter could be a potential biomarker for predicting the low‐risk ECs, but is inferior to tumor volume in performance 25 .…”

“…21,22 In this study, we found significant differences in tumor volume between the adjacent risk groups, the low-and non-low-risk EEAs, and the (low + intermediate)-and (high-intermediate + high)risk EEAs, suggesting that tumor volume has the potential to stratify the risk of EEAs. Similarly, Chen et al 23 and Cai et al 24 reported that the maximal tumor diameter could be a potential biomarker for predicting the low-risk ECs, but is inferior to tumor volume in performance. 25 Nevertheless, the results should be interpreted with caution in clinical practice because tumor size or volume is easily affected by preoperative endometrial sampling, which is usually performed before MRI.…”