title: Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results.
abstract: Our purpose is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC) measurement in differentiating malignant from benign uterine endometrial cavity lesions. We retrospectively evaluated 25 uterine endometrial cavity lesions in 25 female patients: endometrial carcinoma (n = 11), carcinosarcoma (n = 2), submucosal leiomyoma (n = 8), and endometrial polyp (n = 4). Diffusion-weighted images were performed at 1.5 T with b factors of 0-1,000/mm(2). The region of interest was defined within the tumor on T2-weighted EPI image and then manually copied to an ADC map. Thereby, the ADC value was obtained. We compared ADC values between malignant and benign lesions using Student's t-test. The mean and standard deviation of ADC values (x10(-3) mm(2)/s) were as follows: endometrial carcinoma, 0.98+/-0.21; carcinosarcoma, 0.97+/-0.02; submucosal leiomyoma, 1.37+/-0.28; and endometrial polyp, 1.58+/-0.45. The ADC values differed significantly between malignant (0.98+/-0.19) and benign lesions (1.44+/-0.34) (P < 0.01). We defined malignant tumors as cases with an ADC value less than 1.15 x 10(-3) mm(2)/s for obtaining the highest accuracy. Sensitivity, specificity, and accuracy were 84.6%, 100%, and 92%, respectively. ADC measurement can provide useful information in differentiating malignant from benign uterine endometrial cavity lesions.
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, Tottori 683-8504, Japan. sfujii@grape.med.tottori-u.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujii
authors.forename: Eiji
authors.initials: E
authors.lastname: Matsusue
authors.forename: Junzo
authors.initials: J
authors.lastname: Kigawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Sato
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kanasaki
authors.forename: Junko
authors.initials: J
authors.lastname: Nakanishi
authors.forename: Shuji
authors.initials: S
authors.lastname: Sugihara
authors.forename: Toshio
authors.initials: T
authors.lastname: Kaminou
authors.forename: Naoki
authors.initials: N
authors.lastname: Terakawa
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007889:Leiomyoma / Q000175:diagnosis*; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity