Prediction of histological grade of endometrial cancer by means of MRI

Bonatti, Matteo; Pedrinolla, Beatrice; Cybulski, Adam; Lombardo, Fábio; Negri, Giovanni; Messini, S; Tagliaferri, Tiziana; Manfredi, Riccardo; Bonatti, Giampietro

doi:10.1016/j.ejrad.2018.04.008

Cited by 26 publications

(36 citation statements)

References 18 publications

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“…If this trait is not eminent, ADC values could be greater, thereby maximizing potential overlaps between different grades of tumors (18). However, previous research that has evaluated ADC values in EC were interpreted conjointly with T1W images or T2W images (13, 14, 22), supporting that the superior contrast resolution of 3.0-T MRI is one of the main reasons for improved ADC accuracy in this investigation.…”

Section: Discussionsupporting

confidence: 69%

“…(19), who demonstrated an inverse association between ADC mean values and histologic grade in patients with EC. However, findings from other large studies have yielded contradictory results, suggesting that any differences in ADC values (mean, min, or max) between tumor’s grade are relatively minor, if they exist at all (7, 13, 14, 22).…”

Section: Discussionmentioning

confidence: 96%

“…Lastly, it is worth noting that the histologic grade and depth of the myometrial invasion were correlated positively (as grade becomes less differentiated, there is a greater tendency for deep invasion), which predicts the association between myometrial invasion depth and ADC values (22, 35–38). However, exceptions do exist, as 9% of G1 lesions had deep muscle invasion, while 7% of G3 lesions were limited to the endometrium, supporting the belief that poorly differentiated tumors might have a tendency to invade the myometrium deeply, but they do not necessarily coexist (38).…”

Section: Discussionmentioning

confidence: 97%

“…(7), and Bonatti et al. (22) were obtained at 1.5-T MRI, while in this work, the studies were taken at 3.0-T MRI for all patients to enhance the signal-to-noise ratio. Available data show that the sensitivity of 1.5 T is lower than that of 3.0 T in evaluating parametrial status and lymph node metastasis in EC (23, 24).…”

Section: Discussionmentioning

confidence: 99%

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The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

et al. 2020

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Background Diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) measurement provides additional information about tumor microstructure with potential relevance for staging and predicting aggressive disease in patients with endometrial cancer (EC). Purpose To determine whether ADC values in EC diverge according to the tumor’s histologic grade and myometrial invasion depth. Material and Methods A sample of 48 pathologically confirmed cases of EC were reviewed retrospectively. The sample was distributed as follows: G1 (n = 9); G2 (n = 18); G3 (n = 21); with myometrial invasion <50% (n = 31); and with myometrial invasion ≥50% (n = 17). DW images were performed at 3.0T with b factors of 0–1000/mm2. The region of interest (ROI) was defined within the tumor with T1-weighted and T2-weighted imaging and copied manually to an ADC map. The tumor’s grade and myometrial invasion’s depth were determined by postoperative histopathological tests. Results The means of ADCmin and ADCmean values were significantly lower for patients with G2 and G3 endometrial tumors than G1. The same tendency was observed in myometrial invasion, as both ADCmin and ADCmean values were lower for patients with deep than for those with superficial myometrial invasion. The cut-off values of the ADCmin and ADCmean that predicted high-grade tumors were 0.69 × 10−3 mm2/s and 0.82 × 10−3 mm2/s, respectively, while those for myometrial infiltration were 0.70 × 10−3 mm2/s (ADCmin) and 0.88 × 10−3 mm2/s (ADCmean). Conclusion ADCmin and ADCmean values correlated with histologic tumor grade and myometrial invasion depth; therefore, it is suggested that ADC on MRI may be a useful indicator to predict malignancy of ECs.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

et al. 2020

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“…However, they found no correlation between ADC values and tumor grade. Bonatti et al [51] recently demonstrated that the presence of deep myometrial infiltration and a tumor/uterus volume ratio of > 0.13 correlated with high-grade EC, whereas ADC values were not useful for predicting the histological grade of EC. Inada et al [48] found that using DWI and T2WI improved the staging accuracy of myometrial invasion, with a sensitivity of up to 96%.…”

Section: Mri Technique For Endometrial and Cervical Cancersmentioning

confidence: 99%

Role of MRI in staging and follow-up of endometrial and cervical cancer: pitfalls and mimickers

et al. 2019

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MRI plays important roles in endometrial and cervical cancer assessment, from detection to recurrent disease evaluation. Endometrial cancer (EC) is the most common malignant tumor of the female genital tract in Western countries. EC patients are divided into risk categories based on histopathological tumor type, grade, and myometrial invasion depth. EC is surgically staged using the International Federation of Gynecology and Obstetrics (FIGO) system. Since FIGO (2009) stage correlates with prognosis, preoperative staging is essential for tailored treatment. MRI reveals myometrial invasion depth, which correlates with tumor grade and lymph node metastases, and thus correlates with prognosis. Cervical cancer (CC) is the second most common cancer, and the third leading cause of cancer-related death among females in developing countries. The FIGO Gynecologic Oncology Committee recently revised its CC staging guidelines, allowing staging based on imaging and pathological findings when available. The revised FIGO (2018) staging includes node involvement and thus enables both therapy selection and evaluation, prognosis estimation, and calculation of end results. MRI can accurately assess prognostic indicators, e.g., tumor size, parametrial invasion, pelvic sidewall, and lymph node invasion. Despite these important roles of MRI, radiologists still face challenges due to the technical and interpretation pitfalls of MRI during all phases of endometrial and cervical cancer evaluation. Awareness of mimics that can simulate both cancers is critical. With careful application, functional MRI with DWI and DCE sequences can help establish a correct diagnosis, although it is sometimes necessary to perform biopsy and histopathological analysis.

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Staging MRI of uterine malignant mixed Müllerian tumors versus endometrial carcinomas with emphasis on dynamic enhancement characteristics

et al. 2019

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Prediction of histological grade of endometrial cancer by means of MRI

Cited by 26 publications

References 18 publications

The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

Role of MRI in staging and follow-up of endometrial and cervical cancer: pitfalls and mimickers

Staging MRI of uterine malignant mixed Müllerian tumors versus endometrial carcinomas with emphasis on dynamic enhancement characteristics

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