Purpose of this study is : To assess the efficacy of dynamic contrast enhanced MRI and diffusion weighted imaging in the preoperative assessment & staging of endometrial & cervical carcinoma and accordingly stratification of best treatment options. Methods The study included 40 patients having uterine malignancy 20 with endometrial carcinoma and 20 with cervical carcinoma (between 32 and 76 years) referred from Gynecologists to Radiodiagnosis Department after histologic diagnosis. Each patient was subjected to full history taking, routine laboratory investigations, preliminary trans-vaginal ultrasound and MR examination including: Conventional MRI, DCE-MRI and DWI. All cases were staged with the aid of T2WIs, DCE-MRI & DWI. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips). Results The study showed that DCE-MRI & DWI improve the accuracy of T2WI in staging of endometrial & cervical cancer. Conclusion Using DCE-MRI & DWI improves differentiation of tumor & non-tumor tissue in cervical and endometrial cancer, thus improves the accuracy of pre-surgical mapping, assessment of treatment response and prediction of treatment outcome. That will be without increasing the expected morbidity from unnecessary procedures and accordingly increase the overall patient’s survival.
Background: The purpose of this study is to investigate the role of proton MR spectroscopy (1H-MRS) in the characterization and diagnosis of ovarian lesions. Results: From October 2015 to October 2017, a total of 57 female patients (65 adnexal lesions; 8 cases were bilateral) were included. The examined lesions were classified according to their histopathological findings, (37 (57%) benign lesions, 4 (6%) borderline lesions, and 24 (37%) malignant lesions). The mean choline/creatinine (CHO/ Cr) ratio was 1.29 ± 0.98 SD for malignant lesions, while the mean value in borderline lesions was 0.63 ± 0.15 SD, and the mean value for the benign lesions was 0.65 ± 0.34. Therefore, the mean CHO/Cr ratio was much higher in malignant than in benign lesions, which was statistically significant (P ≤ 0.001) as well as between the borderline and invasive lesions (P = 0.05), but not between the benign and borderline lesions. The diagnostic performance of conventional MRI in diagnosing adnexal lesions was 100%, specificity was 76%, and accuracy was 86%. However, MRS individual diagnostic performances are the following: sensitivity 89%, specificity, and 100% with an accuracy of 95%. Conclusion: MRS proved to be an accurate and efficient method for the analysis of adnexal lesions and in differentiation between benign and malignant tumors.
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