Preoperative Evaluation of Myometrial Invasion in Endometrial Carcinoma: Prospective Intra-individual Comparison of Magnetic Resonance Volumetry, Diffusion-weighted and Dynamic Contrast-enhanced Magnetic Resonance Imaging

Thieme, Stefan Felix; Collettini, Federico; Sehouli, Jalid; Biocca, Lucio; Lella, Alessandra; Wagner, Moritz; Almuheimid, Jumana; Plett, Helmut; Muallem, Mustafa Zelal

doi:10.21873/anticanres.12791

Cited by 16 publications

(9 citation statements)

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“…The injection rate of 2 mL/s is the most commonly used in DEC-MRI. In a previous study, it was reported that sensitivity, specificity, and accuracy were 92.3%, 86.4%, and 88.6%, respectively, when DEC-MRI was used for the diagnosis of EC (15). Our study had similar accuracy to the previous study.…”

Section: Discussionsupporting

confidence: 84%

“…In pediatric patients, a low peripheral intravenous gadoteric acid injection rate of 1 mL/s may be better than a higher injection rate in differentiating the grades of brain tumor (14). Thieme et al reported in their study that an injection rate of 2 mL/s could be of great significance in the preoperative evaluation of EC biological characteristics (15). Nevertheless, there has been no further study on the effect of flow rate of contrast medium on image quality and parameter sensitivity of DCE-MRI in EC.…”

Section: Introductionmentioning

confidence: 99%

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Injection rate of contrast medium affects diagnostic ability of dynamic contrast-enhanced magnetic resonance imaging for endometrial carcinoma: a prospective cohort study

Xu¹,

Jin²,

Ge³

et al. 2021

Gland Surg

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Background: Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) can obtain semiquantitative or quantitative parameters of tumors by capturing the images before and after injection of contrast medium. However, there has been no further research on the effect of flow rate of contrast medium on image quality and parameter sensitivity of DCE-MRI in endometrial carcinoma (EC).Methods: This was a prospective cohort study enrolling patients who were suspected of EC between January 2018 and June 2020. The baseline data of participants were collected. Post-surgical histological examination acted as the gold standard of EC diagnosis and some characteristics of tumors were recorded.We calculated 3 important parameters of DCE-MRI, including volume transfer constant (K trans ), flux rate constant (K ep ), and extravascular extracellular volume fraction (V e ), according to the MRI system. The image quality in DCE-MRI imaging was evaluated according to contrast, resolution, artifact, signal-to-noise ratio, and scanning time. To evaluate the diagnostic ability of DCE-MRI with different injection rate, receiver operating characteristic (ROC) curve was generated and the area under curve (AUC) was calculated.Results: According to the different injection rate of contrast medium, participants were divided into three groups, including 2, 3, and 4 mL/s group. It was found that there were more grade 1 EC in the 3 mL/s group (52.4%) than other two groups (34.3% and 23.3%, respectively), and the difference was significant (P=0.021).No other significant differences were found among all other variables. It was found that K trans was much higher in the 4 mL/s group than in other two groups (P<0.001). Also, V e was much higher in the 4 mL/s group than in other two groups (P<0.001). However, no significant difference was found in K ep between three groups (P=0.633). Besides, the 4 mL/s group had the highest quality of all three groups (P<0.001). The sensitivity, specificity, and accuracy were highest in 4 mL/s group. The AUC in three groups were 0.822, 0.832, and 0.888 in the 2, 3, and 4 mL/s group, respectively. Conclusions:The DCE-MRI measurement is useful for the diagnosis of EC, and faster injection rate may be beneficial to improve diagnostic accuracy and image quality.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Injection rate of contrast medium affects diagnostic ability of dynamic contrast-enhanced magnetic resonance imaging for endometrial carcinoma: a prospective cohort study

Xu¹,

Jin²,

Ge³

et al. 2021

Gland Surg

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“…The 3D metric method, which is one of these, is easily performed in daily practice and does not require special software (11,15). In the segmentation method, volumes are calculated with the help of computer software (10,12,13). In the present study, measurements were made in both ways to compare the effectiveness of these two different methods.…”

Section: Discussionmentioning

confidence: 99%

Endometrial cancer: the role of MRI quantitative assessment in preoperative staging and risk stratification

et al. 2021

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Background New methods to reduce subjectivity in preoperative magnetic resonance imaging (MRI) staging of endometrial cancer are needed. Purpose To investigate the role of MRI quantitative assessment in staging and risk stratification of endometrial cancer. Material and Methods Preoperative T2-weighted (T2W) images and diffusion-weighted imaging of 42 patients were analyzed retrospectively by two radiologists. Tumor area ratio (TAR) and tumor volume ratio (TVRseg) were calculated by semi-automatic segmentation of the tumor and uterus on T2W imaging and apparent diffusion coefficient (ADC). TVR was also calculated by the 3D metric method (TVRmetric). Mean ADCtumor was calculated. The patients were allocated to risk groups regarding the stage, grade, and lymphovascular invasion (LVI) status. Results TAR, TVRmetric, T2W TVRseg, and ADC TVRseg showed a significant difference between the superficial and deep myometrial invasion groups ( P < 0.001). All of these parameters showed a good diagnostic performance for detecting deep myometrial invasion (AUC>0.82), the highest accuracy rate (85%) was found with T2W TVRseg. LVI was significantly associated with TAR ( P = 0.002) and T2W TVRseg ( P = 0.014), while the cervical invasion was associated with TAR ( P = 0.03). ADCtumor was significantly lower in high-grade tumors ( P = 0.002). There was a significant difference in ADCtumor ( P = 0.002), TAR ( P = 0.004), and T2W TVRseg ( P = 0.038) between the low- and high-risk groups. AUC of TAR and T2W TVRseg for detecting high-risk groups were 0.80 and 0.77, respectively, while AUC of ADCtumor for the low-risk group was 0.75. Conclusion MRI quantitative assessments such as TAR, TVR, and ADCtumor may improve the accuracy of preoperative staging and can help in risk stratification of endometrial cancer.

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“…Beddy et al. [ 51 ] suggest that DWI is more precise in assessing gynecological malignancy based on the International Federation of Gynecology and Obstetrics (FIGO) staging and might potentially replace DCE-MRI in the presurgical staging of EC [ 70 ]. DWI is also superior to DCE-MRI in reliability and reproducibility [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review

Winarto

Habiburrahman²,

Siregar³

et al. 2022

Radiology Case Reports

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Preoperative Evaluation of Myometrial Invasion in Endometrial Carcinoma: Prospective Intra-individual Comparison of Magnetic Resonance Volumetry, Diffusion-weighted and Dynamic Contrast-enhanced Magnetic Resonance Imaging

Cited by 16 publications

References 0 publications

Injection rate of contrast medium affects diagnostic ability of dynamic contrast-enhanced magnetic resonance imaging for endometrial carcinoma: a prospective cohort study

Injection rate of contrast medium affects diagnostic ability of dynamic contrast-enhanced magnetic resonance imaging for endometrial carcinoma: a prospective cohort study

Endometrial cancer: the role of MRI quantitative assessment in preoperative staging and risk stratification

Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review

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