title: Interest of diffusion-weighted echo-planar MR imaging and apparent diffusion coefficient mapping in gynecological malignancies: a review.
abstract: Magnetic resonance imaging (MRI) remains the standard modality for the local staging of gynecological malignancies but it has several limitations, particularly for lymph node staging or evaluating peritoneal carcinomatosis. Consequently, there has been a growing interest in functional imaging modalities. Based on molecular diffusion, diffusion-weighted imaging (DWI) is a unique, noninvasive modality that provides excellent tissue contrast and was shown to improve the radiological diagnosis of malignant tumors. Using quantitative apparent diffusion coefficient (ADC) measurement of DWI provides a new tool for better distinguishing malignant tissues from benign tumors. The aim of the present review is to report on the results of DWI for the assessment of patients with gynecological malignancies. An analysis of the literature suggests that DWI studies would improve the diagnosis of cervical and endometrial tumors. It may also improve the assessment of tumor extension in patients with peritoneal carcinomatosis from gynecological malignancies. However, since the signal intensity of some cancers can range from high intensity to low intensity, a degree of uncertainty was demonstrated due to the proximity of the normal uterine myometrium and ovaries. Interestingly, there is also evidence that ADC might improve the follow-up and monitoring of patients who receive anticancer therapies, including chemotherapy or radiation therapy.
authors.affiliation: Université Paris XI, Department of Radiology, Gustave Roussy Institute, Villejuif, France.
authors.forename: Antonin
authors.initials: A
authors.lastname: Levy
authors.forename: Aïcha
authors.initials: A
authors.lastname: Medjhoul
authors.forename: Caroline
authors.initials: C
authors.lastname: Caramella
authors.forename: Elise
authors.initials: E
authors.lastname: Zareski
authors.forename: Oscar
authors.initials: O
authors.lastname: Berges
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Bérénice
authors.initials: B
authors.lastname: Boulet
authors.forename: François
authors.initials: F
authors.lastname: Bidault
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D002584:Cervix Uteri / Q000473:pathology; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008495:Medical Oncology / Q000379:methods; D009215:Myometrium / Q000473:pathology; D009362:Neoplasm Metastasis; D010051:Ovarian Neoplasms / Q000473:pathology; D010053:Ovary / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014594:Uterine Neoplasms / Q000473:pathology; D014599:Uterus / Q000473:pathology