title: Utility of histogram analysis of apparent diffusion coefficient maps obtained using 3.0T MRI for distinguishing uterine carcinosarcoma from endometrial carcinoma.
abstract: We explored the role of histogram analysis of apparent diffusion coefficient (ADC) maps for discriminating uterine carcinosarcoma and endometrial carcinoma.
  
  
  
  We retrospectively evaluated findings in 13 patients with uterine carcinosarcoma and 50 patients with endometrial carcinoma who underwent diffusion-weighted imaging (b = 0, 500, 1000 s/mm(2) ) at 3T with acquisition of corresponding ADC maps. We derived histogram data from regions of interest drawn on all slices of the ADC maps in which tumor was visualized, excluding areas of necrosis and hemorrhage in the tumor. We used the Mann-Whitney test to evaluate the capacity of histogram parameters (mean ADC value, 5th to 95th percentiles, skewness, kurtosis) to discriminate uterine carcinosarcoma and endometrial carcinoma and analyzed the receiver operating characteristic (ROC) curve to determine the optimum threshold value for each parameter and its corresponding sensitivity and specificity.
  
  
  
  Carcinosarcomas demonstrated significantly higher mean vales of ADC, 95th, 90th, 75th, 50th, 25th percentiles and kurtosis than endometrial carcinomas (P < 0.05). ROC curve analysis of the 75th percentile yielded the best area under the ROC curve (AUC; 0.904), sensitivity of 100%, and specificity of 78.0%, with a cutoff value of 1.034 × 10(-3) mm(2) /s.
  
  
  
  Histogram analysis of ADC maps might be helpful for discriminating uterine carcinosarcomas and endometrial carcinomas. J. Magn. Reson. Imaging 2016;43:1301-1307.
authors.affiliation: Department of Diagnostic Radiology, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Diagnostic Radiology, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Eito
authors.initials: E
authors.lastname: Kozawa
authors.affiliation: Department of Diagnostic Radiology, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Tanisaka
authors.affiliation: Department of Gynecologic Oncology, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Kousei
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Pathological Diagnosis, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Diagnostic Radiology, Saitame Medical University International Medical Center, Saitama, Japan.
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D002296:Carcinosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: ADC; MR; apparent diffusion coefficient; histogram analysis; uterine carcinosarcoma