Influence of menopausal status on diagnostic accuracy of myometrial invasion in endometrial cancer: diffusion-weighted and dynamic contrast-enhanced MRI at 3 T. Issue 11 (November 2015)

• Record Type: Journal Article
• Authors: Lin, G.; Huang, Y.-T.; Chao, A.; Ng, K.-K.; Yang, L.-Y.; Ng, S.-H.; Lai, C.-H.
• Is Part Of: Clinical radiology. Volume 70:Issue 11(2015)
• Page Start: 1260
• Page End: 1268
• Publication Date: 2015-11
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2015.06.097
• Languages: English
• ISSNs: 0009-9260

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title id="sectitle0010">Aim</title> <p id="abspara0010">To assess the influence of menopausal status on the diagnostic accuracy of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for evaluating myometrial invasion in patients diagnosed with endometrial cancer.</p> </sec> <sec> <title id="sectitle0015">Materials and methods</title> <p id="abspara0015">In this prospective study, 91 consecutive female patients diagnosed with endometrial cancer were enrolled for preoperative evaluation using 3 T MRI. Two radiologists interpreted myometrial invasion depth on DW (b=1000 s/mm<sup>2</sup>) and DCE MRI images, with surgical histopathology as the reference standard. Statistical methods included kappa statistics for evaluating reader agreement and diagnostic performance analysis between pre- and postmenopausal groups.</p> </sec> <sec> <title id="sectitle0020">Results</title> <p id="abspara0020">Reader agreement of DW MRI was poor (κ=0.20) for premenopausal patients. The diagnostic accuracy of DW MRI in detecting myometrial involvement was significantly lower in premenopausal compared with postmenopausal patients (0.42 versus 0.73, <italic>p</italic>=0.006). There was no difference in the diagnostic accuracy of DW MRI in detecting deep myometrial invasion between premenopausal and postmenopausal groups (0.94 versus 0.95, <italic>p></italic>0.99).</p> </sec> <sec> <title id="sectitle0025">Conclusion</title> <p id="abspara0025">For premenopausal patients who plan to receive fertility-preserving treatment for endometrial cancer, DCE MRI is superior to DW MRI in excluding any possible myometrial invasion. For preoperative assessment of deep myometrial invasion, DW MRI can be a legitimate alternative to DCE MRI regardless of menopausal status and is particularly beneficial for patients at risk of nephrogenic systemic fibrosis.</p> </sec> </abstract>