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Diffusion-weighted imaging versus dynamic contrast-enhanced imaging for pre-operative diagnosis of deep myometrial invasion in endometrial cancer: A meta-analysis

  • Li-Jen Wang
    Affiliations
    Department of Medical Imaging and Intervention, New Taipei Municipal Tu Cheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fu-Hsing Street, Guishan, 33333 Taoyuan, Taiwan
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  • Yi-Ju Tseng
    Affiliations
    Department of Information Management, National Central University, 300, Zhongda Rd., Zhongli District, Taoyuan City 320317, Taiwan
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  • Nicole Kessa Wee
    Affiliations
    Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, 308433, Singapore
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  • Jeffrey Jen Hui Low
    Affiliations
    Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, National University Hospital, Head of Gynaecologic Oncology, National University Cancer Institute, Singapore, 5 Lower Kent Ridge Rd, 119074, Singapore
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  • Cher Heng Tan
    Correspondence
    Corresponding author at: Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, 308 433, Singapore.
    Affiliations
    Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, 308433, Singapore

    Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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      Highlights

      • Assessing deep myometrial invasion in endometrial cancers can be performed with magnetic resonance imaging.
      • There was no significant difference in diagnostic performance between DWI and DCE-MRI for diagnosis of deep myometrial invasion in endometrial cancer.
      • Diffusion weighted imaging may be preferred for its ease of use in clinical practice.

      Abstract

      Purpose

      This study investigates the differences in diagnostic performance between diffuse-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE), either alone or in combination with T2-weighted imaging (T2WI), for diagnosing deep myometrial invasion (dMI) of endometrial cancers (EC).

      Methods

      We performed a comprehensive search for published studies comparing DWI and DCE for preoperatively diagnosing dMI of EC. The overall diagnostic accuracy of each test was calculated using the areas under the summary receiver operating characteristic curves (AUCs). The sensitivities and specificities were compared using bivariate meta-regression.

      Results

      Pooled analysis of nineteen studies with 961 patients (main group) showed that DWI had a larger AUC (0.943, 95% confidence interval (CI) = 0.921–0.967) than DCE (0.922, 95% CI = 0.893–0.953). For the subgroup comprising 7 studies, DWI combined with T2WI and DCE combined with T2WI showed AUCs of 0.959 (95% CI, 0.932–0.986) and 0.929 (95% CI, 0.847–1.000), respectively. None of the differences in AUCs were statistically significant. All comparisons of the sensitivities and specificities of the main group and subgroup also showed no significant differences.

      Conclusion

      This meta-analysis found no significant difference in diagnostic performance between DWI and DCE for diagnosis of dMI in EC. DWI may be preferred for its ease of use in clinical practice.

      Keywords

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