Background Endometrial carcinoma (EC) risk stratification is generally based on histological assessment. It would be beneficial to perform risk stratification noninvasively by MRI. Purpose To investigate the application of amide proton transfer‐weighted imaging (APTWI), monoexponential, biexponential, and stretched exponential intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) for the evaluation of risk stratification in early‐stage EC. Study Type Prospective. Population Eighty patients with early‐stage EC (47 classified as low risk, 20 as medium risk, and 13 as high risk by histological grade and International Federation of Gynecology and Obstetrics stage). Field Strength/Sequence T1‐weighted imaging, T2‐weighted imaging, IVIM, APTWI, and DKI MRI at 3 T. Assessment The magnetization transfer ratio asymmetry (MTRasym [3.5 ppm]), apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), water molecular diffusion heterogeneity index (α), mean kurtosis (MK), and mean diffusivity (MD) were calculated and compared between low‐risk and non‐low‐risk groups. Statistical Tests Individual sample t test, analysis of variance, and logistic regression. A P‐value <0.05 was considered statistically significant. Results The α, ADC, D, DDC, and MD were significantly higher and the f, MK, and MTRasym (3.5 ppm) were significantly lower in the low‐risk group than in the non‐low‐risk group. The difference in D* between the two groups was not significant (P = 0.289). MTRasym (3.5 ppm), D, and MK were independent predictors of risk stratification. The combination of these three parameters was better able to identify low‐ and non‐low‐risk groups than each individual parameter. Data Conclusion The IVIM, DKI, and APTWI parameters have potential as imaging markers for risk stratification in early‐stage EC. Level of Evidence 2 Technical Efficacy Stage 3

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Background Amide proton transfer‐weighted imaging (APTWI) and intravoxel incoherent motion imaging (IVIM) are valuable MRI techniques applied to cancer. Purpose To compare APTWI and IVIM in the diagnosis of benign and malignant breast lesions and to evaluate the correlations between different parameters (MTRasym [3.5 ppm], D, D*, and f) and prognostic factors for breast cancer. Study Type Retrospective. Population In all, 123 breast lesions were studied before treatment, including 58 benign lesions and 65 malignant lesions. Field Strength/Sequence Conventional MRI (T1WI, T2WI, and diffusion‐weighted imaging [DWI]), APTWI, and IVIM MRI at 3T. Assessment The magnetization transfer ratio asymmetry at 3.5 ppm (MTRasym [3.5 ppm]), diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) values were compared between the benign and malignant groups and between groups with different expression levels of prognostic factors. Statistical Tests Individual sample t‐test, χ2 test, Spearman correlation, logistic regression, and the Delong test. Results The D and MTRasym (3.5 ppm) values of the malignant group were lower than those of the benign group; however, D* and f values were higher than those of the benign group (all P < 0.05). The areas under the curve (AUCs) of D, MTRasym (3.5 ppm), D*, and f were 0.809, 0.778, 0.670, and 0.766, respectively; however, only the difference between AUC (D) and AUC (D*) was significant (Z = 2.374, P < 0.05). The D value showed a low correlation with the pathological grade and Ki‐67 expression (| r | = 0.294, 0.367); the f value showed a low correlation with estrogen receptor (ER) expression (| r | = 0.382); and the MTRasym (3.5 ppm) value showed a low correlation with pathological grade (| r | = 0.371). Data Conclusion This analysis revealed that both IVIM and APTWI could be used for the differential diagnosis of benign and malignant breast lesions, and APTWI‐derived MTRasym (3.5 ppm), IVIM‐derived D, D*, and f values showed correlations with some prognostic factors for breast cancer. Level of Evidence 2 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2020;52:1175–1186.