Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
To compare T2-weighted image (T2WI) and conventional Diffusion-weighted image (cDWI) of magnetic resonance imaging (MRI) for sensitivity of qualitative diagnosis and accuracy of tumor size (TS) measurement in endometrial cancer (EC). Meanwhile, the effect of the lesion size itself and tumor grade on the ability of T2WI and cDWI of TS assessment was explored. Ultimately, the reason of deviation on size evaluation was studied.
34 patients with EC were enrolled. They were all treated with radical hysterectomy and performed MR examinations before operation. Firstly, the sensitivity of T2WI alone and T2WI–DWI in qualitative diagnosis of EC were compared according to pathology. Secondly, TS on T2WI and cDWI described with longitudinal (LD) and horizontal diameter (HD) were compared to macroscopic surgical specimen (MSS) quantitatively in the entire lesions and the subgroup lesions which grouped by postoperative tumor size itself and tumor grade. Thirdly, the discrepancy of mean ADC values (ADC mean) and range ADC values (ADC range) between different zones of EC were explored.
For qualitative diagnosis, the sensitivity of T2WI–DWI (97%) was higher than T2WI alone (85%) (p = 0.046).For TS estimation, no significant difference (PLD = 0.579; PHD = 0.261) was observed between T2WI (LDT2WI = 3.90 cm; HDT2WI = 2.88 cm) and MSS (LD = 4.00 cm; HD = 3.06 cm), whereas TS of cDWI (LDDWI = 3.01 cm; HDDWI = 2.54 cm) were smaller than MSS (PLD = 0.002; PHD = 0.002) in all lesions. In subgroup of tumor with G1 (grade 1) and small lesion (defined as maximum diameter < 3 cm), both T2WI and cDWI were not significantly different from MSS; In subgroup of tumor with G2 + 3 (grade 2 and grade 3) and big lesion (maximum diameter ≥ 3 cm), T2WI matched well with MSS still, but DWI lost accuracy significantly. The result of ADC values between different zones of tumor showed ADC mean of EC rose from central zone to peripheral zone of tumor gradually and ADC range widened gradually.
cDWI can detect EC very sensitively. The TS on cDWI was smaller than the fact for the ECs with G2/3 and big size. The TS of T2WI was in accordance with the actual size for all ECs. The heterogeneity may be responsible for the inaccuracy of cDWI.
Terry K L, Missmer S A.Epidemiology of Ovarian and Endometrial Cancers[J].Pathology and Epidemiology of Cancer,2017,6(4):233-246.
Kececi I S, Nural M S, Aslan K, et al. Efficacy of diffusion-weighted magnetic resonance imaging in the diagnosis and staging of endometrial tumors[J]. Diagnostic & Interventional Imaging, 2015, 97(2):177-186.
Thoeny H C, Froehlich J M, Triantafyllou M, et al. Metastases in normal-sized pelvic lymph nodes: detection with diffusion-weighted MR imaging.[J]. Journal of Urology, 2014, 273(1):125-35.
Bourgioti C, Chatoupis K, Tzavara C, et al. Predictive ability of maximal tumor diameter on MRI for high-risk endometrial cancer[J]. Abdominal Radiology, 2016, 41(12):1-12.
Yukiharu T,Hidemichi Wi,Kazuhira O,et al. Tumor volume successively reflects the state of disease progression in endometrial cancer[J]. Gynecologic Oncology.2013,129(3):472-477.
Julian C. Schink, Alfred W. David Scott M, et al.Tumor Size in Endometrial Cancer[J]. Cancer.1991,67(11):2791-2794.
Todo Y, Choi H J, Kang S, et al. Clinical significance of tumor volume in endometrial cancer: A Japan–Korea cooperative study[J]. Gynecologic Oncology, 2013, 131(2):294-298
Desimone C, Elder J, Edwards A, et al. Endometrial cancer lesion size is predictive of disease recurrence and long-term survival[J]. Gynecologic Oncology, 2013, 130(1):e71.
Ytre-Hauge S, Husby J A, Magnussen I J, et al. Preoperative Tumor Size at MRI Predicts Deep Myometrial Invasion, Lymph Node Metastases, and Patient Outcome in Endometrial Carcinomas[J]. International Journal of Gynecological Cancer, 2015, 25(3):459-466.
Bonatti M, Stuefer J, Oberhofer N, et al. MRI for local staging of endometrial carcinoma: Is endovenous contrast medium administration still needed?[J]. European Journal of Radiology, 2015, 84(2):208-214.
Mourad A F, Mousa E M. Comparing T2 weighted images/diffusion weighted imaging and T2 weighted images/dynamic contrast enhanced MRI for endometrial carcinoma myometrial invasion[J]. The Egyptian Journal of Radiology and Nuclear Medicine, 2017, 48(1):323-327.
Inada Y, Matsuki M, Nakai G, Tatsugami F, Tanikake M,Narabayashi I, et al. Body diffusion-weighted MR imaging of uterine endometrial cancer: is it helpful in the detection ofcancer in non-enhanced MR imaging.[J] Eur J Radiol 2009; 70:122-7. Epub 2008 Jan 7.
Masroor I, Zeeshan M, Afzal S, et al. Diffusion weighted MR imaging (DWI) and ADC values in endometrial carcinoma[J]. Journal of the College of Physicians and Surgeons–Pakistan : JCPSP, 2010, 20(11):709-713.
Bhosale P,Ma J, Iyer R,et al. Feasibility of a reduced field-of-view diffusion-weighted (rFOV) sequence in assessment of myometrial invasion in patients with clinical FIGO stage I endometrial cancer.[J]. Journal of Magnetic Resonance Imaging, 2016, 43(2):316-324.
Ota T, Hori M, Onishi H, et al. Preoperative staging of endometrial cancer using reduced field-of-view diffusion-weighted imaging: a preliminary study[J]. European Radiology, 2017.
Shen S H, Chiou Y Y, Wang J H, et al. Diffusion-Weighted Single-Shot Echo-Planar Imaging with Parallel Technique in Assessment of Endometrial Cancer[J]. American Journal of Roentgenology, 2008, 190(2):481-488.
Deng L, Wang Q P, Chen X, et al. The Combination of Diffusion- and T2-Weighted Imaging in Predicting Deep Myometrial Invasion of Endometrial Cancer[J]. Journal of Computer Assisted Tomography, 2015, 39(5):661-673.
Hricak H, Lacey C G, Sandles L G, et al. Invasive cervical carcinoma: comparison of MR imaging and surgical findings[J]. Radiology, 1988, 166(3):623-631.
Mitchell D G, Snyder B, Coakley F, et al. Early invasive cervical cancer: tumor delineation by magnetic resonance imaging, computed tomography, and clinical examination, verified by pathologic results, in the ACRIN 6651/GOG 183 Intergroup Study.[J]. Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 2006, 24(36):5687-94.
Mann R M, Bult P, van Laarhoven H W, et al. Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients.[J]. European Journal of Radiology, 2013, 82(9):1416-22.
Popovtzer A, Ibrahim M, Tatro D, et al. MRI to delineate the gross tumor volume of nasopharyngeal cancers: which sequences and planes should be used?[J]. Radiology & Oncology, 2014, 48(3):323-330.
Rew D A. The importance of heterogeneity in tumor pathology[J]. Advances in Anatomic Pathology, 1998, 5(3):156-63.
Gatius S, Cuevas D, Fernández C, et al. Tumor Heterogeneity in Endometrial Carcinoma: Practical Consequences[J]. Pathobiology Journal of Immunopathology Molecular & Cellular Biology, 2017
Foulds L. The natural history of cancer. J Chronic Dis. 1958;8:2–37.
Kovac M, Navas C, Horswell S, Salm M, Bardella C, Rowan A, et al. Recurrent chromosomal gains and heterogeneous driver mutations characterize papillary renal cancer evolution. Nat Comms. 2015;6:1–11.
Yates LR, Gerstung M, Knappskog S, Desmedt C, Gundem G, Van Loo P, etal. Subclonal diversification of primary breast cancer revealed by multiregion sequencing. Nat Med. 2015;21:751–9.
Nikbakht H, Panditharatna E, Mikael LG, Li R, Gayden T, Osmond M, et al.Spatial and temporal homogeneity of driver mutations in diffuse intrinsicpontine glioma. Nat Comms. 2016;7:11185.
Shin H J, Park J Y, Shin K C, et al. Characterization of tumor and adjacent peritumoral stroma in patients with breast cancer using high-resolution diffusion-weighted imaging: Correlation with pathologic biomarkers[J]. European Journal of Radiology, 2016, 85(5):1004-1011.
Stanta G;Jahn SW;Bonin S,etal.Tumour heterogeneity: principles and practical consequences[J].Virchows Arch,2016,469(4):371-184.
Heusinger K, Löhberg C, Lux M P, et al. Assessment of breast cancer tumor size depends on method, histopathology and tumor size itself*[J]. Breast Cancer Res Treat, 2005, 94(1):17-23.
Mennella S, Garlaschi A, Paparo F, et al. Magnetic resonance imaging of breast cancer: factors affecting the accuracy of preoperative lesion sizing.[J]. Acta Radiologica, 2015, 56(3):260–268.
- Can conventional DWI accurately assess the size of endometrial cancer?
- Springer US
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
Neu im Fachgebiet Radiologie
Meistgelesene Bücher aus der Radiologie
Mail Icon II