DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20212356

Evaluation of apparent diffusion coefficient in endometrial carcinoma compared to normal endometrium: a retrospective study

Anu Sarah Easo, Rajeev Anand, Mini Issac

Abstract


Background: To determine whether diffusion-weighted imaging (DWI) with measurement of apparent diffusion coefficient (ADC) will help in differentiating endometrial cancer from normal endometrium and to determine whether the grades of endometrial cancer will show significant difference in ADC values.

Methods: This is a retrospective study done in MOSC medical college hospital Kolencherry. on patients on whom preoperative MRI was done before hysterectomy. Cases from July 2017 to March 2021 were included. Study cases included 40 females with pathologically confirmed endometrial cancer and 30 females with pathologically proven normal endometrium in cases of uterine leiomyoma and cervical cancer. The exclusion criteria for the study were patients with endometrial cancer in whom surgery was not done within 2 weeks of MRI, patients who were treated with chemotherapy or radiotherapy before surgery, patients who had hydrometra or pyometra.

Results: The mean ADC value (10−3 mm2/second) of endometrial cancer was 0.77±0.04, which was significantly lower (p<0.05) than that of normal endometrium (1.323±0.05). The ADC values of different grades of endometrial cancers did not show any statistically significant difference (p>0.05).

Conclusions: Our study showed that ADC measurement can differentiate between normal endometrium and endometrial cancer. The ADC values of different grades of endometrial cancers did not show any statistically significant difference.  


Keywords


Endometrial cancer, Diffusion weighted imaging, ADC, Endometrial thickening

Full Text:

PDF

References


Jemal A, Murray T, Ward E, Samuels A, Tiwari R, Ghafoor A et al. Cancer Statistics, 2005. CA: A Cancer Journal for Clinicians. 2005;55(1):10-30.

Balasubramaniam G, Sushama S, Rasika B, Mahantshetty U. Hospital-based Study of Endometrial Cancer Survival in Mumbai, India. As Pac J Canc Prevent. 2013;14(2):977-80.

Arora V, Quinn M. Endometrial cancer. Best Practice & Research Clinical Obstetrics & Gynaecology. 2012;26(3):311-24.

Amant F, Mirza M, Creutzberg C. Cancer of the corpus uteri. Int J Gynecol Obstet. 2012;119:S110-7.

Frei K, Kinkel K, Bonél H, Lu Y, Zaloudek C, Hricak H. Prediction of Deep Myometrial Invasion in Patients with Endometrial Cancer: Clinical Utility of Contrast-enhanced MR Imaging-A Meta-analysis and Bayesian Analysis. Radiology. 2000;216(2):444-49.

Kinkel K, Kaji Y, Yu K, Segal M, Lu Y, Powell C et al. Radiologic Staging in Patients with Endometrial Cancer: A Meta-analysis. Radiology. 1999;212(3):711-18.

Koyama T, Tamai K, Togashi K. Staging of carcinoma of the uterine cervix and endometrium. European Radiology. 2007;17(8):2009-19.

Larson D, Connor G, Broste S, Krawisz B, Johnson K. Prognostic significance of gross myometrial invasion with endometrial cancer. Obstetrics & Gynecology. 1996;88(3):394-98.

Berman M, Ballon S, Lagasse L, Watring W. Prognosis and treatment of endometrial cancer. Am J Obstet Gynecol. 1980;136(5):679-88.

Sala E, Rockall A, Rangarajan D, Kubik-Huch R. The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. Europ J Radiol. 2010;76(3):367-85.

Rechichi G, Galimberti S, Signorelli M, Perego P, Valsecchi M, Sironi S. Myometrial invasion in endometrial cancer: diagnostic performance of diffusion-weighted MR imaging at 1.5-T. Europ Radiol. 2009;20(3):754-62.

Sala E, Crawford R, Senior E, Shaw A, Simcock B, Vrotsou K et al. Added Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Predicting Advanced Stage Disease in Patients with Endometrial Carcinoma. Int J Gynecol Canc. 2009;19(1):141-46.

Wright J, Medel N, Sehouli J, Fujiwara K, Herzog T. Contemporary management of endometrial cancer. The Lancet. 2012;379(9823):1352-60.

Tirumani SH, Shanbhogue AK, Prasad SR. Current concepts in the diagnosis and management of endometrial and cervical carcinomas. Radiol Clin North Am. 2013;51:1087-110.

Creasman W. Revised FIGO staging for carcinoma of the endometrium. Int J Gynecol Obstet. 2009;105(2):109-109.

Beddy P, O'Neill A, Yamamoto A, Addley H, Reinhold C, Sala E. FIGO Staging System for Endometrial Cancer: Added Benefits of MR Imaging. RadioGraphics. 2012;32(1):241-54.

Manfredi R, Gui B, Maresca G, Fanfani F, Bonomo L. Endometrial cancer: magnetic resonance imaging. Abdominal Imaging. 2005;30(5):626-36.

Szafer A, Zhong J, Gore J. Theoretical Model for Water Diffusion in Tissues. Magnet Resonan Med. 1995;33(5):697-712.

Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, Ito S, Akashi T et al. Relationship between bone marrow cellularity and apparent diffusion coefficient. J Magnet Reson Imag. 2001;13(5):757-60.

Castillo M, Smith JK, Kwock L, Wilber K. Apparent diffusion coefficients in the evaluation of high-grade cerebral gliomas. AJNR Am J Neuroradiol. 2001;22:60-4.

Tamai K, Koyama T, Saga T, Umeoka S, Mikami Y, Fujii S et al. Diffusion-weighted MR imaging of uterine endometrial cancer. J Magnet Resonan Imag. 2007;26(3):682-7.

Rechichi G, Galimberti S, Signorelli M, Franzesi C, Perego P, Valsecchi M et al. Endometrial Cancer: Correlation of Apparent Diffusion Coefficient with Tumor Grade, Depth of Myometrial Invasion, and Presence of Lymph Node Metastases. Am J Roentgenol. 2011;197(1):256-62.

Woo S, Cho J, Kim S, Kim S. Histogram analysis of apparent diffusion coefficient map of diffusion-weighted MRI in endometrial cancer: a preliminary correlation study with histological grade. Acta Radiologica. 2014;55(10):1270-7.

Nougaret S, Reinhold C, Alsharif S, Addley H, Arceneau J, Molinari N et al. Endometrial Cancer: Combined MR Volumetry and Diffusion-weighted Imaging for Assessment of Myometrial and Lymphovascular Invasion and Tumor Grade. Radiology. 2015;276(3):797-808.

Seo J, Kim C, Choi D, Kwan Park B. Endometrial cancer: Utility of diffusion-weighted magnetic resonance imaging with background body signal suppression at 3T. J Magnet Resonan Imag. 2012;37(5):1151-59.

Fujii S, Matsusue E, Kigawa J, Sato S, Kanasaki Y, Nakanishi J et al. Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results. European Radiology. 2007;18(2):384-9.

Kilickesmez O, Bayramoglu S, Inci E, Cimilli T, Kayhan A. Quantitative diffusion-weighted magnetic resonance imaging of normal and diseased uterine zones. Acta Radiologica. 2009;50(3):340-7.