Diagnostic Accuracy of Dynamic Contrast Enhanced Magnetic Resonance Imaging and Diffusion-Weighted Imaging in Endometrial Carcinoma: a Retrospective Study on 54 Cases

The potential of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to reflect the histological subtype and clinical course in endometrial cancers is not fully elucidated. This study was to evaluate the efficacy of DCE-MRI and DWI in the diagnosis of endometrial carcinoma. Fifty-four patients with endometrial carcinoma were retrospectively studied. DWI and DCE-MRI images were acquired preoperatively in all patients. The depth of myometrial invasion, dynamic enhanced characteristics, time-signal intensity curve and ADC values suggested by preoperative DW/DCE-MRI and the subsequent histopathological findings following the surgery were investigated. The statistical difference was analyzed using SPSS 17.0. Endometrial adenocarcinoma was found in 83.3 % (45/54) cases including 14 cases of highly differentiated (G1), 28 cases of moderately differentiated (G2) and 3 cases of poorly differentiated (G3) according to DWI. There were no statistical difference (P > 0.05) in signal intensity and ADC value of internal obturator muscle among G1, G2 and G3. ADC value between G1 and G2 had statistical difference. Postoperative histopathological examination showed that 79.6 % (43/54) patients were at stage Ia, 16.7 % (9/54) at stage Ib and 3.7 % (2/54) at stage II according to the FIGO 2012 staging criteria. DCE-MRI results showed 74.1 % (40/54) patients were at stage Ia, 14.8 % (8/54) at stage Ib and 3.7 % (2/54) at stage II. Based on the results of histopathological examination, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value of diagnosing endometrial adenocarcinoma la, lb, II by DCE-MRI were 93.0, 88.9, 100 %; 90.9, 93.3, 100 %; 92.6, 92.6, 100 %; 97.6, 72.7, 100 %; 76.9, 97.7, 100 %. The results suggested that DWI and DCE-MRI are helpful in improving the accuracy of the staging and pathological grading of endometrial carcinoma.