The Added Role of Diffusion Weighted Imaging in the Staging of Endometrial Carcinoma
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- Category: Vol. 85, June 2017
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The Added Role of Diffusion Weighted Imaging in the Staging of Endometrial Carcinoma, SHERIHAN F. DAKHLY, WALID M. EL-KHAYAT and DORRIA S. SALEM
Abstract
Objective: To assess the value of Diffusion Weighted Imaging (DWI) versus Dynamic Contrast Enhanced MRI (DCE-MRI) in the staging of endometrial carcinoma.
Methodology: Twenty five cases of pathologically proved endometrial cancer prior staging subjected to dynamic post contrast technique: One pre-and six post contrast phases (40sec. each). DWI was scanned using different p-values, ADC values were measured and fusion images (T2/DWI) were automatically generated.
Results: DWI was the most accurate in overall staging (93.3%). Deep myometrial invasion was overestimated in 1 case in both DWI and DCE-MRI versus 3 cases in conventional MR imaging. In assessment of cervical stromal invasion, they all perform equally with overestimation in only 1 case. DWI is the modality of choice for assessment of locally advanced carcinomas; sensitivity, positive predictive value and accuracy of 100%. In metastatic lymph nodes, DCE-MR showed the least accuracy of 86%.
Conclusion: DWI (with fusion images) is valuable in overall staging of endometrial cancer owing to its superiority in evaluation of locally advanced disease and metastatic deposits. DCE-MR can delineate local tumors and exclude bladder/rectal invasion.