Correlation of apparent diffusion coefficient value with prognostic parameters of endometrioid carcinoma

Inoue, Chie; Fujii, Shinya; Kaneda, Sachi; Fukunaga, Takanobu; Kaminou, Toshio; Kigawa, Junzo; Harada, Tasuku; Ogawa, Toshihide

doi:10.1002/jmri.24534

Cited by 42 publications

(47 citation statements)

References 44 publications

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“…Previous studies have also shown a correlation between DTI parameters and tumor histologic grades in cerebral gliomas, breast cancer, and renal cancer; specifically, FA values tended to be lower with greater grade of malignancy, and this tendency may be due to intratumoral heterogeneity and higher cellular density . Previous studies have shown that differentiating among histologic grades of EMCs based on conventional ADC values is often difficult because of the considerable overlap among these values . Therefore, our data support the observation that DTI is more accurate than conventional DWI for differentiating among histologic grades of carcinomas.…”

Section: Discussionsupporting

confidence: 87%

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Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Yamada

Wakana

Kobayashi

et al. 2018

Magnetic Resonance Imaging

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Background Although the prognosis of endometrial carcinoma (EMC) patients strictly depends on tumor invasion depth and its histologic grade, accurate preoperative assessment of these prognostic factors is often difficult. Purpose To determine the usefulness of diffusion‐tensor imaging (DTI) as a noninvasive method for evaluating tumor invasion depth and its histologic grade in patients with EMC. Study Type Prospective. Population Twenty‐five consecutive patients with histologically confirmed EMC who were surgically treated at our institution. Field Strength/Sequence DTI was performed with a 1.5T MRI system using a single‐shot echo‐planar imaging sequence with b values of 0 and 1000 s/mm2 and motion‐probing gradients in nine noncollinear directions. Assessment Fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD) maps were analyzed by three observers and compared with histopathologic findings. Statistical Tests Dunnett's test, Spearman's rank correlation coefficient, and receiver operating characteristic (ROC) curve analyses. Results FA maps from all patients distinctly identified the junctional zone as a high‐FA zone (0.864 ± 0.037) that was significantly different from the endometrium and outer myometrium (0.251 ± 0.030 and 0.471 ± 0.091, respectively; P < 0.001). All EMCs were clearly depicted as hypointense areas on all DTI maps. AD maps provided the best tumor‐to‐uterus contrast, and EMCs (0.977 ± 0.120 × 10−3 mm2/s) had significantly lower AD values than all other layers of the normal uterine wall (2.166 ± 0.408, 2.010 ± 0.289, and 2.655 ± 0.203 × 10−3 mm2/s, respectively; P < 0.001). EMCs were clearly demarcated from the normal uterine wall, and DTI maps and histopathologic data yielded identical findings regarding tumor invasion depth. FA values showed a significant inverse correlation (r = –0.818; P < 0.001) with histologic grades 1, 2, and 3 of endometrioid adenocarcinomas. Data Conclusion In patients with EMC, DTI may be useful for evaluating tumor invasion depth and its histologic grade. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:250–260.

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Section: Discussionsupporting

confidence: 87%

“…However, accurate preoperative assessment of these prognostic factors is often difficult using conventional MRI. More important, although the histologic grade correlates with other prognostic factors and provides critical information for selecting treatment plans, accurately predicting histologic grade without a needle biopsy remains challenging …”

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confidence: 99%

Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Yamada

Wakana

Kobayashi

et al. 2018

Magnetic Resonance Imaging

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“…Minimum ADC (ADC min ) represents the highest tumor cellularity. Studies have shown that both SUV max derived from PET/CT and ADC min of the primary tumor of endometrial cancer are associated with pathological prognostic factors and are independent predictive factors for disease recurrence, whereas SUV max has also been shown to be an independent prognostic factor for overall survival …”

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confidence: 99%

Standardized uptake value and apparent diffusion coefficient of endometrial cancer evaluated with integrated whole‐body PET/MR: Correlation with pathological prognostic factors

Shih

Yen

Chen

et al. 2015

Magnetic Resonance Imaging

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“…When compared to benign lesions, malignant tumors show higher cellularity, and thereby lower ADC min and higher SUV max values (23,24). Although various studies suggested a possible relationship between the SUV max and ADC min of the primary tumor and tumor characteristics such as grade, myometrial invasion, stage, recurrence, and survival (13,14,25,26,27), uncertainty remains regarding the true magnitude and structure of these relationships as there are limited data that compare both parameters in the same study group.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer

Budak¹,

Toptaş²,

Aydın

et al. 2017

Mirt

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Objective:To explore the correlation of the primary tumor’s maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin) with clinicopathologic features, and to determine their predictive power in endometrial cancer (EC).Methods:A total of 45 patients who had undergone staging surgery after a preoperative evaluation with 18F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) were included in a prospective case-series study with planned data collection. Multiple linear regression analysis was used to determine the correlations between the study variables.Results:The mean ADCmin and SUVmax values were determined as 0.72±0.22 and 16.54±8.73, respectively. A univariate analysis identified age, myometrial invasion (MI) and lymphovascular space involvement (LVSI) as the potential factors associated with ADCmin while it identified age, stage, tumor size, MI, LVSI and number of metastatic lymph nodes as the potential variables correlated to SUVmax. In multivariate analysis, on the other hand, MI was the only significant variable that correlated with ADCmin (p=0.007) and SUVmax (p=0.024). Deep MI was best predicted by an ADCmin cutoff value of ≤0.77 [93.7% sensitivity, 48.2% specificity, and 93.0% negative predictive value (NPV)] and SUVmax cutoff value of >20.5 (62.5% sensitivity, 86.2% specificity, and 81.0% NPV); however, the two diagnostic tests were not significantly different (p=0.266).Conclusion:Among clinicopathologic features, only MI was independently correlated with SUVmax and ADCmin. However, the routine use of 18F-FDG PET/CT or DW-MRI cannot be recommended at the moment due to less than ideal predictive performances of both parameters.

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Correlation of apparent diffusion coefficient value with prognostic parameters of endometrioid carcinoma

Abstract: The minimum ADC correlates with prognostic parameters of endometrial carcinoma more strongly than mean ADC. Lower minimum ADC is associated with higher histological tumor grade and higher degree of myometrial invasion.

Cited by 42 publications

References 44 publications

Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Standardized uptake value and apparent diffusion coefficient of endometrial cancer evaluated with integrated whole‐body PET/MR: Correlation with pathological prognostic factors

Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer

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