title: Perfusion and diffusion characteristics of endometrial malignancy based on intravoxel incoherent motion MRI at 3.0 T: comparison with normal endometrium.
abstract: BACKGROUND
  There has been a growing need for a non-invasive imaging method for the accurate diagnosis and differentiation of endometrial malignancy (EM).
  
  
  OBJECTIVE
  To study tissue characteristics of EM using an intravoxel incoherent motion (IVIM) model and to assess their diagnostic potential.
  
  
  METHODS
  Sixty-eight EMs and 31 healthy participants were prospectively recruited for diffusion-weighted (13 b-values, b = 0-3,000 s/mm(2)) and standard magnetic resonance imaging (MRI). A bi-exponential analysis was performed to derive f (perfusion fraction), D* (pseudodiffusion coefficient), and D (true diffusion coefficient) in EM and normal endometrium (NE). Apparent diffusion coefficient (ADC) was calculated. Student's t test, the Mann-Whitney U test and a receiver operating characteristics (ROC) curve analysis were performed.
  
  
  RESULTS
  EM had lower f (37.809 ± 12.158%) and was significantly different from NE (P < 0.001). However, the EMs had higher D (0.503 ± 0.155 × 10(-3) mm(2)/s) and D* (19.796 ± 20.029 × 10(-3) mm(2)/s) and were all significantly different from NE (P < 0.001). D was significantly lower than ADC in NE (P < 0.001) but not in EM (P > 0.05). f ≤ 48.5%, D > 0.432 × 10(-3) mm(2)/s, D* > 4.94 × 10(-3) mm(2)/s, and ADC ≤ 0.542 × 10(-3) mm(2)/s could diagnose EM (AUC 0.786-0.961).
  
  
  CONCLUSIONS
  EM has distinctive IVIM perfusion and diffusion characteristics with promising potential for earlier non-invasive diagnosis.
authors.affiliation: No. 2 Department of Radiology, Tianjin Hospital, Tianjin, China, PR China.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Liu
authors.affiliation: No. 2 Department of Radiology, Tianjin Hospital, Tianjin, China, PR China 13920468453@163.com.
authors.forename: Yeda
authors.initials: Y
authors.lastname: Wan
authors.affiliation: No. 2 Department of Radiology, Tianjin Hospital, Tianjin, China, PR China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Wang
authors.affiliation: No. 2 Department of Radiology, Tianjin Hospital, Tianjin, China, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Gynecologic Oncology, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin, China, PR China.
authors.forename: Pengpeng
authors.initials: P
authors.lastname: Qu
authors.affiliation: Department of Pathology, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin, China, PR China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D011446:Prospective Studies
keywords: Intravoxel incoherent motion (IVIM); diffusion; diffusion-weighted imaging (DWI); endometrial malignancy; perfusion