T2 relaxometry mapping in demonstrating layered uterine architecture: parameter optimization and utility in endometrial carcinoma and adenomyosis: a feasibility study

Abstract

Thinning and irregularity of the myometrial fourth layer in cases of endometrial malignancy might help in identification of superficial myoinvasion-this might be a new imaging armamentarium in nulliparous females where uterine preservation might be a consideration. The T relaxation times of the myometrium and endometrium described here will help optimize the time to echo for the acquisition of MSE for relaxometry of the female pelvis. Advances in knowledge: Thinning and irregularity of the fourth myometrial layer helps in the identification of superficial myometrial invasion with a greater confidence and helps triage patients for uterine preservation when necessary. T relaxometry might be undertaken in those nulliparous women with endometrial carcinoma in whom demonstration of no myometrial invasion will make them candidates for uterine preservation. Thickening of the fourth myometrial layer in adenomyosis requires further evaluation in a larger cohort of patients as an additional imaging finding. T relaxation times of endometrial carcinoma is different from the normal endometrium in the three cases imaged, thus, further studies evaluating the T values in a larger cohort might help in differentiating diseased from the healthy endometrium. T time of the pelvic tissue described in the study will help select the time to echoes for MSE imaging of the female pelvis in further studies.

T2* relaxometry maps of the uterus – Future prospectives with oncology implications

“…We obtained T2 relaxometry maps of endometrial and cervical cancer patients, in axial and sagittal planes, with a larger FOV and shorten acquisition time than previously mentioned [9,10]. We demonstrated T2 relaxometry values of endometrial and cervical cancer, metastatic lymphadenopathy, small bowel and rectum (Table 1).…”

“…T2 relaxometry studies focused on the pelvis area, are still at the beginning. Imaoka et al have previously demonstrated the layered uterine structure and Ghosh et al emphasized the use of the T2 maps in diagnostic of endometrial cancer and adenomyosis, with a protocol that included multiple TE (echo time) per patient /acquisition [9,10].…”

Role of T2 mapping of magnetic resonance imaging in the differentiation of endometrial cancer and benign endometrial lesions

“…33 The T2 value of NE was significantly higher than that of BELs in this study. Ghosh et al 20 reported that the T2 map can show the uterus with four layers. The thin fourth layer was more hypointense than the junctional zone and was observed between the endometrium and the junctional zone.…”

“…A short article reported that T2 mapping demonstrated a new layer, namely the linear submucosal myometrium of the uterine architecture, in one patient with adenomyosis and two patients with EC. 20 The difference in the myometrial architecture could partly be attributed to the difference in water content in the endometrium; 21 the T2 value was related to the water content. To the best of our knowledge, no study focusing on T2 mapping for the differentiation of EC has been reported.…”

Study of T2 mapping in quantifying and discriminating uterine lesions under different magnetic field strengths: 1.5 T vs. 3.0 T

“…As a quantitative technique, T2 mapping is objective, reproducible, stable, and suitable for patients with renal function insufficiency or gadolinium allergy due to its gadolinium-free nature [ 5 ]. It has been applied to a number of diseases, including prostate tumors [ 6 , 7 ], breast tumors [ 8 ], ovarian cancer [ 9 ], uterine endometrial carcinoma [ 10 ], osteoarthritis [ 11 , 12 ] and myocardial-related diseases [ 13 , 14 ]. However, it is well known that the T2 value of certain tissues decreases with increasing magnetic field strength.…”