Highlights
- •Accurate preoperative delineation of endometrial cancer invasiveness is important.
- •Myometrial invasion depth may be used as a surrogate marker to determine metastasis.
- •EADC value obtained at peri-endometrial zone can predict deep myometrial invasion.
- •Coupled with subjective MR images, prediction accuracy can be enhanced.
- •This helps tailor surgical intervention for endometrial cancer patients.
Abstract
Purpose
To evaluate whether the combination of subjective magnetic resonance imaging (MRI)
and quantitative analysis by using the exponential ADC (EADC) value of the peri-endometrial
zone can improve the diagnostic performance of deep myometrial invasion in endometrial
cancer patients.
Materials and methods
We prospectively evaluated 111 patients with either cervical cancer (normal endometria
group) or endometrial cancer (endometrial cancer group). Two radiologists assessed
all preoperative MR images with T1, T2, and diffusion-weighted imaging. The EADC value
of the peri-endometrial zone was measured. Sensitivity, specificity, positive and
negative predictive values, and the area under the receiver operating characteristic
curve (Az) were calculated for Subjective MRI, an EADC cutoff value of the peri-endometrial
zone and the combination of the two methods in assessing the prediction of deep myometrial
invasion.
Results
Specificity for EADC cutoff of the peri-endometrial zone was higher (0.93) than for
Subjective MRI (0.80), as were the positive predictive values (EADC, 0.79; visual,
0.60). Sensitivity for the combined test was higher (0.88) than for Subjective MRI
(0.71) and the EADC cutoff value (0.65), as were the negative predictive values (the
combined test, 0.94; vs. EADC, 0.79; vs. Subjective MRI, 0.60). There were no differences in Az between the three methods
(P > 0.05), but the combined test had the highest Az.
Conclusions
Combined with conventional Subjective MRI, calculating EADC value of the peri-endometrial
zone could improve the accuracy of preoperative assessment of deep myometrial invasion
in endometrial cancer patients, and maybe helpful in tailoring a surgical approach
for intervention.
Keywords
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Article info
Publication history
Published online: February 10, 2017
Accepted:
January 20,
2017
Received in revised form:
November 26,
2016
Received:
June 21,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
