Diagnostic utility of apparent diffusion coefficient in preoperative assessment of endometrial cancer: are we ready for the 2023 FIGO staging?

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING BMC Medical Imaging Pub Date : 2024-08-28 DOI:10.1186/s12880-024-01391-5

Gehad A Saleh, Rasha Abdelrazek, Amany Hassan, Omar Hamdy, Mohammed Salah Ibrahim Tantawy

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Abstract

Background: Although endometrial cancer (EC) is staged surgically, magnetic resonance imaging (MRI) plays a critical role in assessing and selecting the most appropriate treatment planning. We aimed to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging (DWI) in preoperative assessment of EC.

Methods: Prospective analysis was done for sixty-eight patients with pathology-proven endometrial cancer who underwent MRI and DWI. Apparent diffusion coefficient (ADC) values were measured by two independent radiologists and compared with the postoperative pathological results.

Results: There was excellent inter-observer reliability in measuring ADCmean values. There were statistically significant lower ADCmean values in patients with deep myometrial invasion (MI), cervical stromal invasion (CSI), type II EC, and lympho-vascular space involvement (LVSI) (AUC = 0.717, 0.816, 0.999, and 0.735 respectively) with optimal cut-off values of ≤ 0.84, ≤ 0.84, ≤ 0.78 and ≤ 0.82 mm²/s respectively. Also, there was a statistically significant negative correlation between ADC values and the updated 2023 FIGO stage and tumor grade (strong association), and the 2009 FIGO stage (medium association).

Conclusions: The preoperative ADCmean values of EC were significantly correlated with main prognostic factors including depth of MI, CSI, EC type, grade, nodal involvement, and LVSI.

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表观扩散系数在子宫内膜癌术前评估中的诊断效用：我们为 2023 年 FIGO 分期做好准备了吗？

背景：尽管子宫内膜癌（EC）是通过手术分期的，但磁共振成像（MRI）在评估和选择最合适的治疗方案方面发挥着至关重要的作用。我们旨在评估弥散加权成像（DWI）定量分析在子宫内膜癌术前评估中的诊断性能：方法：我们对 68 例接受核磁共振成像和 DWI 检查的病理证实子宫内膜癌患者进行了前瞻性分析。由两名独立的放射科医生测量表观弥散系数（ADC）值，并与术后病理结果进行比较：结果：在测量 ADC 平均值时，观察者之间的可靠性非常高。子宫肌层深部浸润（MI）、宫颈基质浸润（CSI）、II型EC和淋巴管间隙受累（LVSI）患者的ADC均值明显较低（AUC分别为0.717、0.816、0.999和0.735），最佳临界值分别为≤0.84、≤0.84、≤0.78和≤0.82 mm2/s。此外，ADC值与2023年更新的FIGO分期和肿瘤分级（强相关）以及2009年的FIGO分期（中等相关）之间存在统计学意义上的显著负相关：EC的术前ADC均值与主要预后因素（包括MI深度、CSI、EC类型、分级、结节受累和LVSI）显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.