title: Dynamic contrast-enhanced MRI in endometrial carcinoma identifies patients at increased risk of recurrence.
abstract: OBJECTIVE
  To study the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for assessment of tumour microvasculature in endometrial carcinoma patients, and to explore correlations with histological subtype, clinical course and microstructural characteristics based on apparent diffusion coefficient (ADC) values.
  
  
  METHODS
  Diffusion-weighted imaging (DWI) and three-dimensional DCE-MRI (1.5 T) with high temporal resolution (2.49 s) were acquired preoperatively in 55 patients. Quantitative modelling allowed the calculation of four independent parameters describing microvasculature: blood flow (Fb), extraction fraction (E), capillary transit time (Tc) and transfer constant from the extravascular extracellular space [EES] to blood (Kep); and four derived parameters: blood volume (Vb), volume of EES (Ve), capillary permeability surface area product (PS) and transfer from blood to EES (Ktrans).
  
  
  RESULTS
  Endometrial carcinoma tissue exhibited reduced Fb, E, Vb, Ve, PS and Ktrans compared with normal myometrium. Non-endometrioid carcinomas (n = 12) had lower Fb, and E than endometrioid carcinomas (n = 43; P < 0.05). Tumour Ve positively correlated with tumour ADC value (r = 0.29, P = 0.03). Reduced survival was observed in patients with low tumour Fb and high tumour Tc (P < 0.05).
  
  
  CONCLUSIONS
  We demonstrate the feasibility of DCE-MRI in reflecting histological subtype and clinical course in primary endometrial carcinomas. DCE-MRI may potentially provide future biomarkers for preoperative risk stratification in endometrial carcinomas.
  
  
  CONCLUSIONS
  • Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers new information about endometrial carcinoma. • Pelvic DCE-MRI with subsequent quantitative modelling seems feasible in endometrial carcinoma patients. • Low tumour perfusion is a feature of a more aggressive tumour subtype. • DCE-MRI provides potential biomarkers for preoperative risk stratification in endometrial carcinoma patients.
authors.affiliation: Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, Postbox 7800, 5021, Bergen, Norway, ingfrid.haldorsen@helse-bergen.no.
authors.forename: Ingfrid S
authors.initials: IS
authors.lastname: Haldorsen
authors.forename: Renate
authors.initials: R
authors.lastname: Grüner
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Husby
authors.forename: Inger J
authors.initials: IJ
authors.lastname: Magnussen
authors.forename: Henrica M J
authors.initials: HM
authors.lastname: Werner
authors.forename: Oyvind O
authors.initials: OO
authors.lastname: Salvesen
authors.forename: Line
authors.initials: L
authors.lastname: Bjørge
authors.forename: Ingunn
authors.initials: I
authors.lastname: Stefansson
authors.forename: Lars A
authors.initials: LA
authors.lastname: Akslen
authors.forename: Jone
authors.initials: J
authors.lastname: Trovik
authors.forename: Torfinn
authors.initials: T
authors.lastname: Taxt
authors.forename: Helga B
authors.initials: HB
authors.lastname: Salvesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008536:Meglumine; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control*; D009664:Norway / Q000453:epidemiology; D009942:Organometallic Compounds; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine