title: Endometrial cancer: diagnostic value of quantitative measurements of microvascular changes with DCE-MR imaging.
abstract: OBJECTIVE
  To assess the diagnostic value of dynamic contrast-enhanced (DCE) perfusion-magnetic resonance imaging (MRI) in detection, characterization and grading of endometrial cancer, using histopathological analysis as the standard of reference.
  
  
  METHODS
  Eighty patients with histologically proven endometrial carcinoma who underwent MRI (1.5 T magnet) of the pelvis for staging purposes were enrolled in the study. Each MR examination consisted of multiplanar T2 and T1-weighted turbo spin echo (TSE) sequences and T1-weighted gradient echo sequences before, during and after the administration of contrast medium. For each patient colour perfusion maps were derived from the dynamic sequences using a dedicated workstation. On the maps a region of interest was manually drawn both on normal myometrium and on the endometrial lesion. Then the following perfusion parameters were automatically calculated: relative enhancement (RE, %), maximum enhancement (ME, %), maximum relative enhancement (MRE, %) and time to peak (TTP, s).
  
  
  RESULTS
  All patients underwent total hysterectomy. Histopathological analysis documented: G1 tumour in 21 patients, G2 tumour in 44 patients, G3 tumour in 14 patients and one squamous cell carcinoma. The following mean value perfusion parameters, with corresponding mean standard deviation, were obtained for endometrial cancer: RE (%) = 59.3 ± 36.3; ME (%) = 862.7 ± 475.9; MRE (%) = 75.3 ± 37.6 and TTP (s) = 164.7 ± 78. RE, ME and MRE were lower in tumour lesions than in normal myometrium (p < 0.001) and significantly higher values (p < 0.001) of perfusion parameters were obtained for G1 (well-differentiated) tumours as compared to those in G2 and G3 (moderately and poorly differentiated) lesions.
  
  
  CONCLUSIONS
  DCE perfusion-MRI can provide quantitative information on tissue vascularity, which may be of help in detecting endometrial cancer and in the assessment of tumour grading.
authors.affiliation: Department of Diagnostic Radiology, University of Milano-Bicocca, Milan, Italy, davide.atena@tiscalinet.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Ippolito
authors.forename: Orazio
authors.initials: O
authors.lastname: Minutolo
authors.forename: Anna
authors.initials: A
authors.lastname: Cadonici
authors.forename: Cammillo
authors.initials: C
authors.lastname: Talei Franzesi
authors.forename: Pietro
authors.initials: P
authors.lastname: Bonaffini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Perego
authors.forename: Sandro
authors.initials: S
authors.lastname: Sironi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000150:complications / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media