title: Endometrial cancer: preoperative staging using three-dimensional T2-weighted turbo spin-echo and diffusion-weighted MR imaging at 3.0 T: a prospective comparative study.
abstract: OBJECTIVE
  To prospectively assess the efficacy of 3-T magnetic resonance (MR) imaging using the three-dimensional turbo spin-echo T2-weighted and diffusion-weighted technique (3D-TSE/DW) compared with that of conventional imaging using the two-dimensional turbo spin-echo T2-weighted and dynamic contrast-enhanced technique (2D-TSE/DCE) for the preoperative staging of endometrial cancer, with pathological analysis as the reference standard.
  
  
  METHODS
  Seventy-one women with endometrial cancer underwent MR imaging using 3D-TSE/DW (b = 1,000 s/mm(2)) and 2D-TSE/DCE. Two radiologists independently assessed the two imaging sets. Accuracy, sensitivity, and specificity for staging were analysed with the McNemar test; the areas under the receiver operating characteristic curve (Az) were compared with a univariate z-score test.
  
  
  RESULTS
  The results for assessing deep myometrial invasion, accuracy, sensitivity, specificity and Az, respectively, were as follows: 3D-TSE/DW-observer 1, 87 %, 95 %, 85 % and 0.96; observer 2, 92 %, 84 %, 94 % and 0.95; 2D-TSE/DCE-observer 1, 80 %, 79 %, 81 % and 0.89; observer 2, 86 %, 84 %, 87 % and 0.86. Most of the values were higher with 3D-TSE/DW without significant differences (P > 0.12). For assessing cervical stromal invasion, there were no significant differences in those values for both observers (P > 0.6).
  
  
  CONCLUSIONS
  Accuracy of 3D-TSE/DW was at least equivalent to that of the conventional technique for the preoperative assessment of endometrial cancer.
  
  
  CONCLUSIONS
  • New techniques in MR imaging help assess patients with endometrial cancer. • A 3D T2-weighted TSE sequence seems equally as accurate as conventional techniques. • Three-dimensional TSE/DW imaging does not require intravenous contrast material and is relatively quick. • Tumour extent of endometrial cancer can be clearly shown on diffusion-weighted images. • Junctional zone can be visualised well on 3D-TSE T2-weighted images.
authors.affiliation: Department of Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. mhori@radiol.med.osaka-u.ac.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hori
authors.forename: Tonsok
authors.initials: T
authors.lastname: Kim
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Onishi
authors.forename: Izumi
authors.initials: I
authors.lastname: Imaoka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kagawa
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueguchi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Tatsumi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tomiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000737:chemistry; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D015588:Observer Variation; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media