Dynamic Contrast-Enhanced MR Imaging of Endometrial Cancer: Optimizing the Imaging Delay for Tumour-Myometrium Contrast

Park, Sung Bin; Moon, Min Hoan; Sung, Chang Kyu; Oh, Sohee; Lee, Young Ho

doi:10.1007/s00330-014-3327-2

Cited by 18 publications

(20 citation statements)

References 17 publications

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“…On T2WI, endometrial cancer has the same or lower SI than the normal endometrium and stands out against low SI inner myometrium (junctional zone, JZ) (99, 100). On DCE-MRI, most tumors enhance homogenously, as well as slower and less intensely than the myometrium, with peak myometrial enhancement and maximal tumor-to-myometrium contrast occurring about 90–120 seconds after intravenous administration of contrast medium (101, 102). On DWI, tumor has high SI on high-b-value images and low SI on ADC maps relative to the myometrium (103–106).…”

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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Historically, cancer treatment has emphasized measures for the “cure” regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of Magnetic Resonance Imaging (MRI) in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.

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Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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“…Before May 2014, our institution conducted dynamic CE MRI as a standard part of preoperative MRI for endometrial cancer. Based on scienti c evidence [15], we adopted single-phase CE MRI instead of dynamic CE MRI in May 2014. We retrospectively searched our database for women who underwent single-phase CE MRI and surgically proven endometrial cancer, and the last 30 consecutive women were selected as the single-phase CE MRI group.…”

Section: Study Populationmentioning

confidence: 99%

“…T2-weighted imaging (T2WI), contrastenhanced imaging, and diffusion weighted imaging (DWI) are key MRI sequences to assess myometrial invasion of endometrial cancer. Of these, contrast-enhanced MRI (CE MRI) is mostly performed as hightemporal-resolution, dynamic CE MRI [13,8,[14][15][16][17]. However, high-spatial-resolution, single-phase CE MRI is also an option.…”

Section: Introductionmentioning

confidence: 99%

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Contrast-enhanced MRI in women with endometrial cancer: dynamic versus single-phase acquisitions

Lee

Moon

Kim

et al. 2022

Preprint

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Background: The 2019 ESUR guidelines for endometrial cancer recommend performing either dynamic contrast-enhanced MRI (CE MRI) or single-phase CE MRI. However, no study has directly compared these options. Therefore, this study compared dynamic versus single-phase CE MRI for the evaluation of myometrial invasion in women with endometrial cancer.Methods: This retrospective, single-institution comparative study was conducted among women with surgically proven endometrial cancer, including 30 consecutive women with single-phase CE MRI and 30 age- and pathologic stage-matched women with dynamic CE MRI. Three readers independently compared dynamic and single-phase CE MRI in terms of the tumor-myometrium signal intensity (SI) difference ratio, depth of myometrial invasion, image quality, and image number. Pathologic findings served as a reference standard for the depth of myometrial invasion.Results. The estimated mean SI difference ratios of dynamic CE MRI and single-phase CE MRI fell within an equivalence margin of 0.05 (90% confidence intervals; -0.0497 to 0.0165, -0.0226 to 0.0403, -0.0429 to 0.0433, respectively, for readers A, B, and C). The area under the receiver operating characteristic curve for the detection of deep myometrial invasion was not significantly different between the acquisitions (P=0.3315, P=0.3345, and P=0.8593, respectively). Single-phase CE MRI showed significantly better image quality than dynamic CE MRI (P=0.0143, P=0.0042, and P=0.0066, respectively), while the median number of images for dynamic CE MRI was 2.4 times higher than that for single-phase CE MRI.Conclusions. Single-phase acquisition may be a better option for CE MRI in women with endometrial cancer than dynamic acquisition.

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“…In its current guidelines, the European Society of Urogenital Radiology (ESUR) recommends dynamic contrast-enhanced (DCE) MRI for the staging of endometrial carcinomas and for facilitating patient selection before fertility-sparing management in organ-confined endometrial carcinoma and early stage cervical carcinoma that qualifies for trachelectomy (1,2). Numerous studies have shown that multiphasic contrast-enhanced MRI has high diagnostic accuracy for detecting deep myometrial invasion (MI) of endometrial carcinoma, an important prognostic factor that potentially influences not only treatment decisions, but also prognosis (3)(4)(5). Moreover, infiltrations of the bladder and rectal wall in advanced tumor stages can be seen better on contrast-enhanced sequences than on noncontrast-enhanced acquisitions (6).…”

Section: Introductionmentioning

confidence: 99%

Morphological and functional assessment of the uterus: “one-stop shop imaging” using a compressed-sensing accelerated, free-breathing T1-VIBE sequence

et al. 2020

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Background The combination of motion-insensitive, high-temporal, and spatial resolution imaging with evaluation of quantitative perfusion has the potential to increase the diagnostic capabilities of magnetic resonance imaging (MRI) in the female pelvis. Purpose To compare a free-breathing compressed-sensing VIBE (fbVIBE) with flexible temporal resolution (range = 4.6–13.8 s) with breath-hold VIBE (bhVIBE) and to evaluate the potential value of quantifying uterine perfusion. Material and Methods A total of 70 datasets from 60 patients (bhVIBE: n = 30; fbVIBE: n = 40) were evaluated by two radiologists. Only temporally resolved reconstruction (fbVIBE) was performed on 30 of the fbVIBE datasets. For a subset (n = 10) of the fbVIBE acquisitions, a time- and motion-resolved reconstruction (mrVIBE) was evaluated. Image quality (IQ), artifacts, diagnostic confidence (DC), and delineation of uterine structures (DoS) were graded on Likert scales (IQ/DC/DoS: 1 (non-diagnostic) to 5 (perfect); artifacts: 1 (no artifacts) to 5 (severe artifacts)). A Tofts model was applied for perfusion analysis. Ktrans was obtained in the myometrium (Mm), junctional zone (Jz), and cervix (Cx). Results The median IQ/DoS/DC scores of fbVIBE (4/5/5 κ >0.7–0.9) and bhVIBE (4/4/4; κ = 0.5–0.7; P > 0.05) were high, but Artifacts were graded low (fbVIBE/bhVIBE: 2/2; κ = 0.6/0.5; P > 0.05). Artifacts were only slightly improved by the additional motion-resolved reconstruction (fbVIBE/mrVIBE: 2/1.5; P = 0.08); fbVIBE was preferred in most cases (7/10). Significant differences of Ktrans values were found between Cx, Jz, and Mm (0.12/0.21/0.19; P < 0.05). Conclusion The fbVIBE sequence allows functional and morphological assessment of the uterus at comparable IQ to bhVIBE.

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Dynamic Contrast-Enhanced MR Imaging of Endometrial Cancer: Optimizing the Imaging Delay for Tumour-Myometrium Contrast

Abstract: • Recent advances have allowed for MR imaging of high temporal resolution. • Contrast-enhanced MR imaging is helpful for evaluation of endometrial cancer. • An imaging delay of 90 seconds may be optimal.

Cited by 18 publications

References 17 publications

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Contrast-enhanced MRI in women with endometrial cancer: dynamic versus single-phase acquisitions

Morphological and functional assessment of the uterus: “one-stop shop imaging” using a compressed-sensing accelerated, free-breathing T1-VIBE sequence

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