Diagnostic accuracy of MRI for evaluating myometrial invasion in endometrial cancer: a comparison of MUSE-DWI, rFOV-DWI, and DCE-MRI

Abstract

Objectives To compare the image quality of high-resolution diffusion-weighted imaging (DWI) using multiplexed sensitivity encoding (MUSE) versus reduced field-of-view (rFOV) techniques in endometrial cancer (EC) and to compare the diagnostic performance of these techniques with that of dynamic contrast-enhanced (DCE) MRI for assessing myometrial invasion of EC. Methods MUSE-DWI and rFOV-DWI were obtained preoperatively in 58 women with EC. Three radiologists assessed the image quality of MUSE-DWI and rFOV-DWI. For 55 women who underwent DCE-MRI, the same radiologists assessed the superficial and deep myometrial invasion using MUSE-DWI, rFOV-DWI, and DCE-MRI. Qualitative scores were compared using the Wilcoxon signed-rank test. Receiver operating characteristic analysis was performed to compare the diagnostic performance. Results Artifacts, sharpness, lesion conspicuity, and overall quality were significantly better with MUSE-DWI than with rFOV-DWI (p < 0.05). The area under the curve (AUC) of MUSE-DWI, rFOV-DWI, and DCE-MRI for the assessment of myometrial invasion were not significantly different except for significantly higher AUC of MUSE-DWI than that of DCE-MRI for superficial myometrial invasion (0.76 for MUSE-DWI and 0.64 for DCE-MRI, p = 0.049) and for deep myometrial invasion (0.92 for MUSE-DWI and 0.80 for DCE-MRI, p = 0.022) in one observer, and that of rFOV-DWI for deep myometrial invasion in another observer (0.96 for MUSE-DWI and 0.89 for rFOV-MRI, p = 0.048). Conclusion MUSE-DWI exhibits better image quality than rFOV-DWI. MUSE-DWI and rFOV-DWI shows almost equivalent diagnostic performance compared to DCE-MRI for assessing superficial and deep myometrial invasion in EC although MUSE-DWI may be helpful for some radiologists.

Clinical Utility of Diffusion-Weighted Imaging in Gynecological Imaging

“…According to the report on endometrial cancers, MUSE-DWI was superior to DWI with a reduced FOV in terms of artifacts, sharpness, lesion conspicuity, and overall image quality. 100 However, MUSE-DWI is a time-consuming sequence and has a lower signal-to-noise ratio compared with DWI with a reduced FOV. Another method for distortion reduction is the reversed polarity gradient technique.…”

Comparison of MUSE-DWI and conventional DWI in the application of invasive breast cancer and malignancy grade prediction: A comparative study

“…Multiple sensitivity encoding DWI (MUSE-DWI) is a multi-channel segmented echo-planar imaging technique that extends the existing sensitivity encoding by utilizing interleaved trajectory k-space to achieve higher signal-to-noise ratio (SNR) and improved spatial resolution without the need for navigational pulses [ 15 ]. MUSE-DWI has been applied in various areas such as breast, abdomen, hippocampal sclerosis, endometrial cancer, and prostate cancer [ [15] , [16] , [17] , [18] ]. Based on these applications, researchers have found that MUSE-DWI offers higher SNR, image clarity, lower deformation, and image artifacts compared to traditional DWI techniques, leading to better visualization of lesion morphology.…”