Varsha R, Guruvare S, Kadavigere R, Pendem S
Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
Radiography (Lond). 2025 Aug 16:103125. doi: 10.1016/j.radi.2025.103125.
Proper clinical management requires accurate differentiation of benign and malignant endometrial lesions. Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI) are non-invasive MRI methods that have emerged as key tools in this differentiation. This systematic review compares the diagnostic accuracy of IVIM and DKI in evaluating endometrial lesions.
A systematic review of the literature was conducted using pertinent databases. Inclusion criteria were studies that compared IVIM and DKI for the differentiation of benign and malignant endometrial lesions and provided diagnostic performance statistics like area under the curve (AUC), specificity, and sensitivity. Meta-analysis was not performed in this review due to heterogeneity of the included studies, such as variation in b-values, magnetic field strengths of the MRI scanners, no standardized scanning parameters, and differences in Region of interest (ROI) selection as reported in the articles. The risk of bias was assessed using the QUADAS-2 tool.
In total, 11 studies were included, which evaluated endometrial lesions. F, D, D∗, MD, and MK IVIM and DKI parameters had different diagnostic performances, with AUC ranging from 0.601 to 0.98. Sensitivity and specificity also differed widely between studies. The majority of studies used Echo Planar Imaging (EPI) sequences. Risk of bias assessment indicated moderate-to-high methodological quality.
IVIM and DKI could offer promising non-invasive methods for distinguishing endometrial lesions. Yet, differences in methodology and heterogeneity of studies emphasize the necessity for further standardization.
IVIM and DKI MRI can be used as non-invasive quantitative tools to provide insights about tissue microstructure and perfusion characteristics which help clinicians in characterization of endometrial cancers.
恰当的临床管理需要准确区分良性和恶性子宫内膜病变。体素内不相干运动（IVIM）和扩散峰度成像（DKI）是非侵入性MRI方法，已成为这种区分的关键工具。本系统评价比较了IVIM和DKI在评估子宫内膜病变中的诊断准确性。
使用相关数据库对文献进行系统评价。纳入标准为比较IVIM和DKI用于区分良性和恶性子宫内膜病变并提供诊断性能统计数据（如曲线下面积（AUC）、特异性和敏感性）的研究。由于纳入研究的异质性，如b值变化、MRI扫描仪的磁场强度、无标准化扫描参数以及文章中报道的感兴趣区域（ROI）选择差异，本评价未进行荟萃分析。使用QUADAS-2工具评估偏倚风险。
总共纳入了11项评估子宫内膜病变的研究。IVIM和DKI参数F、D、D∗、MD和MK具有不同的诊断性能，AUC范围为0.601至0.98。不同研究之间的敏感性和特异性也有很大差异。大多数研究使用回波平面成像（EPI）序列。偏倚风险评估表明方法学质量为中度至高。
IVIM和DKI可为区分子宫内膜病变提供有前景的非侵入性方法。然而，方法学差异和研究异质性强调了进一步标准化的必要性。
IVIM和DKI MRI可作为非侵入性定量工具，提供有关组织微观结构和灌注特征的见解，有助于临床医生对子宫内膜癌进行特征化。
