title: ADC maps in the prediction of pelvic lymph nodal metastatic regions in endometrial cancer.
abstract: OBJECTIVE
  To evaluate the usefulness of apparent diffusion coefficient (ADC) in discriminating metastatic from non-metastatic pelvic lymph nodal sites in endometrial cancer.
  
  
  METHODS
  This retrospective study included 40 patients with endometrial cancer who underwent MRI [T2-weighted, dynamic T1-weighted images and diffusion-weighted images with body background suppression (DWIBS), b-values 0 and 1,000 s/mm(2)], total hysterectomy and pelvic lymphadenectomy. Lymph nodes identifiable on DWIBS were evaluated, classified into six nodal regions, and for each node ADC values, short- and long-axis diameters were measured by two readers. Histopathological findings and follow-up information served as the reference standard.
  
  
  RESULTS
  Average (± standard deviation) mean and minimum ADC region value (0.87 ± 0.15 and 0.74 ± 0.07 × 10(-3) mm(2)/s) of metastatic sites (n = 7) were significantly lower than those of non-metastatic ones (n = 89; 1.07 ± 0.20 and 1.02 ± 0.20; p-value = 0.010 and 0.0004). Mean short-axis and short-to-long axis ratios of metastatic nodes were 7.47 mm and 0.68. Using the minimum ADC region value with threshold 0.807 × 10(-3) mm(2)/s, sensitivity, specificity, positive and negative predictive value and accuracy were 100 %, 98.3 %, 63.6 %, 100 % and 98.3 %, respectively (reader 1).
  
  
  CONCLUSIONS
  In endometrial cancer, mean and minimum ADC region values of metastatic nodal sites are significantly lower than those found at normal sites.
authors: School of Medicine, University of Milano-Bicocca, Milan, Italy. gilda.rechichi@gmail.com
authors: Gilda
authors: G
authors: Rechichi
authors: Stefania
authors: S
authors: Galimberti
authors: Matteo
authors: M
authors: Oriani
authors: Patrizia
authors: P
authors: Perego
authors: Maria Grazia
authors: MG
authors: Valsecchi
authors: Sandro
authors: S
authors: Sironi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D010388:Pelvis; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA