Diagnostic Radiology department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
BMC Med Imaging. 2024 Aug 28;24(1):226. doi: 10.1186/s12880-024-01391-5.
Although endometrial cancer (EC) is staged surgically, magnetic resonance imaging (MRI) plays a critical role in assessing and selecting the most appropriate treatment planning. We aimed to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging (DWI) in preoperative assessment of EC.
Prospective analysis was done for sixty-eight patients with pathology-proven endometrial cancer who underwent MRI and DWI. Apparent diffusion coefficient (ADC) values were measured by two independent radiologists and compared with the postoperative pathological results.
There was excellent inter-observer reliability in measuring ADCmean values. There were statistically significant lower ADCmean values in patients with deep myometrial invasion (MI), cervical stromal invasion (CSI), type II EC, and lympho-vascular space involvement (LVSI) (AUC = 0.717, 0.816, 0.999, and 0.735 respectively) with optimal cut-off values of ≤ 0.84, ≤ 0.84, ≤ 0.78 and ≤ 0.82 mm/s respectively. Also, there was a statistically significant negative correlation between ADC values and the updated 2023 FIGO stage and tumor grade (strong association), and the 2009 FIGO stage (medium association).
The preoperative ADCmean values of EC were significantly correlated with main prognostic factors including depth of MI, CSI, EC type, grade, nodal involvement, and LVSI.
尽管子宫内膜癌（EC）是通过手术分期的，但磁共振成像（MRI）在评估和选择最合适的治疗计划方面起着至关重要的作用。我们旨在评估扩散加权成像（DWI）定量分析在术前评估 EC 中的诊断性能。
对 68 例经病理证实的子宫内膜癌患者进行前瞻性分析，这些患者均接受了 MRI 和 DWI 检查。两名独立的放射科医生测量了表观扩散系数（ADC）值，并将其与术后病理结果进行比较。
测量 ADCmean 值的观察者间具有极好的可靠性。在深度肌层浸润（MI）、宫颈间质浸润（CSI）、II 型 EC 和淋巴管血管空间浸润（LVSI）的患者中，ADCmean 值显著降低（AUC=0.717、0.816、0.999 和 0.735，最佳截断值分别为≤0.84、≤0.84、≤0.78 和≤0.82mm/s）。此外，ADC 值与更新后的 2023 年 FIGO 分期和肿瘤分级（强关联）以及 2009 年 FIGO 分期（中等关联）呈显著负相关。
EC 的术前 ADCmean 值与主要预后因素，包括 MI 的深度、CSI、EC 类型、分级、淋巴结受累和 LVSI 显著相关。
