title: Diagnostic Accuracy of Diffusion Weighted Magnetic Resonance Imaging in the Detection of Myometrial Invasion in Endometrial Carcinoma.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of Diffusion-Weighted Magnetic Resonance Imaging (DWMRI) in the detection of myometrial invasion in endometrial cancer taking histopathology as gold standard.
  
  
  METHODS
  Cross-sectional validation study.
  
  
  METHODS
  Department of Radiology, The Aga Khan University Hospital, Karachi, from January to December 2012.
  
  
  METHODS
  DWMRI (b-value = 50,400 and 800 s/mm2) was performed in 85 patients of biopsy-proven endometrial carcinoma before hysterectomy using body and spine coil at 1.5 Tesla. DWI was evaluated for presence of myometrial invasion by tumor with histopathology as gold standard. Sensitivity, specificity, the negative predictive value and positive predictive value and accuracy of DWI were assessed against the gold standard.
  
  
  RESULTS
  On DWI, superficial myometrial invasion was found in 42 patients and deep myometrial invasion in 43. On histopathology, superficial myometrial invasion was found in 53 patients and deep myometrial invasion in 32. Hence sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the assessment of myometrial invasion by endometrial tumor on DW images was 90%, 73%, 67%, 92% and 80%, respectively. Diagnostic accuracy of diffusion-weighted magnetic resonance imaging in detection of myometrial invasion in endometrial cancer was 80%.
  
  
  CONCLUSIONS
  DWI is highly accurate in assessing myometrial invasion and can be used as an adjunct to routine MRI for pre-operative evaluation of myometrial invasion of endometrial cancer.
authors.affiliation: Department of Radiology, Dow University of Health Sciences, Karachi.
authors.forename: Marium
authors.initials: M
authors.lastname: Taufiq
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Imrana
authors.initials: I
authors.lastname: Masroor
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003430:Cross-Sectional Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D015203:Reproducibility of Results