Body diffusion-weighted MR imaging of uterine endometrial cancer: is it helpful in the detection of cancer in nonenhanced MR imaging?
OBJECTIVE
In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images.


METHODS
DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p<0.05 considered statistically significant.


RESULTS
In 19 of 23 patients, endometrial cancers were detected only on T2-weighted images. In the remaining 4 patients, of whom two had coexisting leiomyoma, no cancer was detected on T2-weighted images. This corresponds to an 83% detection sensitivity for the carcinomas. When DW images and fused DW images/T2-weighted images were used in addition to the T2-weighted images, cancers were identified in 3 of the remaining 4 patients in addition to the 19 patients (overall detection sensitivity of 96%). The mean ADC value of endometrial cancer (n=22) was (0.97+/-0.19)x10(-3)mm(2)/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p<0.05).


CONCLUSIONS
DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.
Inada
Yuki
Y
Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan. rad068@poh.osaka-med.ac.jp
Matsuki
Mitsuru
M
Nakai
Go
G
Tatsugami
Fuminari
F
Tanikake
Masato
M
Narabayashi
Isamu
I
Yamada
Takashi
T
Tsuji
Motomu
M
D000328:Adult; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D051598:Whole Body Imaging / Q000379:methods*
D003287:Contrast Media