Comparing T2 weighted images/diffusion weighted imaging and T2 weighted images/dynamic contrast enhanced MRI for endometrial carcinoma myometrial invasion

Objectives

To evaluate accuracy of combined T2 and diffusion weighted images (DWI) in comparison to combined T2WI and dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) for assessment of the depth of myometrial invasion.

Methods

Sixty-two patients diagnosed pathologically as endometrial carcinoma underwent MRI pelvis examination. Technique of examination for each patient includes T1 (axial), T2 (axial, sagittal and oblique sagittal) weighted images. Diffusion weighted images were done with b values of 0 and 1000 s/mm². Dynamic contrast enhanced-magnetic resonance imaging done after administration of 0.1 mmol/kg gadolinium at 2 ml/s. The pathological diagnosis used as a gold standard for comparison with imaging.

Results

Diagnostic accuracy, sensitivity, specificity of combined T2/diffusion weighted images (DWI) were 92%, 90% and 95.6% while for combined T2/dynamic contrast enhancement (DCE) were 79%, 77% and 82.6% for myometrial invasion <50%. The diagnostic accuracy, sensitivity, specificity of combined T2/diffusion weighted images (DWI) were 92%, 95.6% and 90% while for the combined T2/dynamic contrast enhancement (DCE) were 79%, 82.6% and 77% for myometrial invasion >50%.

Conclusion

Combined T2WI-DWI has superior diagnostic accuracy compared to combined T2WI-DCE-MRI in assessment of depth of myometrial invasion in endometrial cancer. T2WI-DWI can eliminate contrast material injection especially for patients who cannot tolerate contrast administration.