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01.10.2013 | Urogenital

Dynamic contrast-enhanced MRI in endometrial carcinoma identifies patients at increased risk of recurrence

verfasst von: Ingfrid S. Haldorsen, Renate Grüner, Jenny A. Husby, Inger J. Magnussen, Henrica M. J. Werner, Øyvind O. Salvesen, Line Bjørge, Ingunn Stefansson, Lars A. Akslen, Jone Trovik, Torfinn Taxt, Helga B. Salvesen

Erschienen in: European Radiology | Ausgabe 10/2013

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Abstract

Objectives

To study the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for assessment of tumour microvasculature in endometrial carcinoma patients, and to explore correlations with histological subtype, clinical course and microstructural characteristics based on apparent diffusion coefficient (ADC) values.

Methods

Diffusion-weighted imaging (DWI) and three-dimensional DCE-MRI (1.5 T) with high temporal resolution (2.49 s) were acquired preoperatively in 55 patients. Quantitative modelling allowed the calculation of four independent parameters describing microvasculature: blood flow (Fb), extraction fraction (E), capillary transit time (Tc) and transfer constant from the extravascular extracellular space [EES] to blood (Kep); and four derived parameters: blood volume (Vb), volume of EES (Ve), capillary permeability surface area product (PS) and transfer from blood to EES (Ktrans).

Results

Endometrial carcinoma tissue exhibited reduced Fb, E, Vb, Ve, PS and Ktrans compared with normal myometrium. Non-endometrioid carcinomas (n = 12) had lower Fb, and E than endometrioid carcinomas (n = 43; P < 0.05). Tumour Ve positively correlated with tumour ADC value (r = 0.29, P = 0.03). Reduced survival was observed in patients with low tumour Fb and high tumour Tc (P < 0.05).

Conclusions

We demonstrate the feasibility of DCE-MRI in reflecting histological subtype and clinical course in primary endometrial carcinomas. DCE-MRI may potentially provide future biomarkers for preoperative risk stratification in endometrial carcinomas.

Key Points

• Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers new information about endometrial carcinoma.

• Pelvic DCE-MRI with subsequent quantitative modelling seems feasible in endometrial carcinoma patients.

• Low tumour perfusion is a feature of a more aggressive tumour subtype.

• DCE-MRI provides potential biomarkers for preoperative risk stratification in endometrial carcinoma patients.

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Titel: Dynamic contrast-enhanced MRI in endometrial carcinoma identifies patients at increased risk of recurrence
verfasst von: Ingfrid S. Haldorsen
Renate Grüner
Jenny A. Husby
Inger J. Magnussen
Henrica M. J. Werner
Øyvind O. Salvesen
Line Bjørge
Ingunn Stefansson
Lars A. Akslen
Jone Trovik
Torfinn Taxt
Helga B. Salvesen
Publikationsdatum: 01.10.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2901-3

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Dynamic contrast-enhanced MRI in endometrial carcinoma identifies patients at increased risk of recurrence