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Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

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Abstract

Our purpose is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC) measurement in differentiating malignant from benign uterine endometrial cavity lesions. We retrospectively evaluated 25 uterine endometrial cavity lesions in 25 female patients: endometrial carcinoma (n = 11), carcinosarcoma (n = 2), submucosal leiomyoma (n = 8), and endometrial polyp (n = 4). Diffusion-weighted images were performed at 1.5 T with b factors of 0–1,000/mm2. The region of interest was defined within the tumor on T2-weighted EPI image and then manually copied to an ADC map. Thereby, the ADC value was obtained. We compared ADC values between malignant and benign lesions using Student’s t-test. The mean and standard deviation of ADC values (×10−3 mm2/s) were as follows: endometrial carcinoma, 0.98±0.21; carcinosarcoma, 0.97±0.02; submucosal leiomyoma, 1.37±0.28; and endometrial polyp, 1.58±0.45. The ADC values differed significantly between malignant (0.98±0.19) and benign lesions (1.44±0.34) (P < 0.01). We defined malignant tumors as cases with an ADC value less than 1.15 × 10−3 mm2/s for obtaining the highest accuracy. Sensitivity, specificity, and accuracy were 84.6%, 100%, and 92%, respectively. ADC measurement can provide useful information in differentiating malignant from benign uterine endometrial cavity lesions.

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Acknowledgments

We are grateful to Eiji Yamashita, B.S., Naoki Iwata, B.S., Takuro Tanaka, B.S., and Hiroki Katayama, B.S., for their technical support in obtaining the high-quality MR images used in this study.

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Authors and Affiliations

  1. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Yonago, Tottori, 683-8504, Japan

    Shinya Fujii, Eiji Matsusue, Yoshiko Kanasaki, Junko Nakanishi, Shuji Sugihara, Toshio Kaminou & Toshihide Ogawa

  2. Division of Reproductive-Perinatal Medicine and Gynecological Oncology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan

    Junzo Kigawa, Shinya Sato & Naoki Terakawa

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  1. Shinya Fujii
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  2. Eiji Matsusue
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  10. Toshihide Ogawa
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Correspondence to Shinya Fujii.

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Fujii, S., Matsusue, E., Kigawa, J. et al. Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results. Eur Radiol 18, 384–389 (2008). https://doi.org/10.1007/s00330-007-0769-9

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  • DOI: https://doi.org/10.1007/s00330-007-0769-9

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