The diagnostic precision of apparent diffusion coefficient (ADC) in grading of malignant endometrial lesions compared with histopathological findings

Gharibvand, Mohammad Momen; Ahmadzadeh, Ali; Asadi, Fariba; Fazelinejad, Zahra

doi:10.4103/jfmpc.jfmpc_142_19

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…Presented findings indicated that DWI (93.3 %) was more sensitive than T2WI (86.7 %) and DCE (89.6 %) in distinguishing benign from malignant lesions. This was the same conclusion of study by Gharibvand et al 13 and Masroor et al, 14 the latter of whom reported that DWI is more sensitive to small lesions than T2. Compared to T2WI (91.4 %) and DWI (94.8 %), DCE had the highest specificity (98.4 %).…”

Section: Discussionsupporting

confidence: 88%

The value of dynamic contrast-enhanced MRI and diffusion-weighted sequence in the evaluation of endometrial lesions

Al-Zubaidi,

Joori,

Abdulwahid

2024

Scripta Medica

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Background/Aim: Endometrial abnormalities represent a diagnostic challenge due to overlapping imaging features with normal endometrium. Aim of this study was to assess accuracy of dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging (MRI) in evaluation of endometrial lesions in comparison with T2 and to assess local staging validity and degree of myometrial invasion in malignancy. Methods: Forty patients with abnormal vaginal bleeding or sonographic thickened endometrial were recruited. MRI examination of pelvis was per-formed using 1.5 T scanner with a pelvic array coil. Conventional T1-and T2, dynamic contrast-enhanced (DCE) sequences and diffusion-weighted image (DWI) were performed. Results: Mean age of patients was 53.2 years and 60 % of patients COM-plained of post-menopausal bleeding. Irregular margin, type III enhancement curve, a high signal in T2WI and DWI and low signal of apparent diffusion coefficient (ADC) were significantly associated with malignancy. The optimum ADC threshold value for distinguishing benign from malignant endometrial lesions was 0.905 × 10 -3 mm 2 /S, with 95.5 % sensitivity and 92.9 % specificity. DWI was most sensitive to malignant endometrial lesions, followed by DCE (89.6 %, 98.4 %) and T2 (86.7 %, 91.4 %). DWI and DCE staging correlated with FIGO staging (p = 0.0001 and p = 0.019, respectively). DWI had the best sensitivity for myometrial invasion (95.6 %), followed by DCE (91.9 %) and T2WI (90.1 %). All three sequences had 89.7 % specificity. Conclusion: DWI and DCE MRI were superior to conventional MRI at distinguishing malignant from benign endometrial lesions and can improve myometrial invasion depth evaluation and therapy planning when COM-bined with morphological T2WI. ADC cutoff at a high b value improved MRI diagnostic sensitivity and specificity.

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Section: Discussionsupporting

confidence: 88%

The value of dynamic contrast-enhanced MRI and diffusion-weighted sequence in the evaluation of endometrial lesions

Al-Zubaidi,

Joori,

Abdulwahid

2024

Scripta Medica

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“…In the current study, benign lesions were present in 68.9% of female patients, with endometrial polyp and simple endometrial hyperplasia being the most common, as in the study of Elsammak et al and Gharibvand et al (17,21). Literature data point to a risk of progression of endometrial hyperplasia to EC up to 5% for endometrial hyperplasia without cell atypia and even 30% in the case of hyperplasia with atypia (30).…”

Section: Discussionsupporting

confidence: 76%

“…In previous research the most attention has been devoted to examining the role of DWI and ADC in the differentiation of EC from various benign endometrial lesions in a more precise diagnosis of EC, as well as to the possibility of determining its histological grade (10,(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

et al. 2023

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IntroductionMagnetic resonance imaging (MRI) with its innovative techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), increases the diagnostic accuracy in distinguishing between malignant and benign lesions of the endometrium. The aim of the study was MRI differentiation between malignant and benign endometrial lesions and correlation with histopathological findings with a special emphasis on quantitative analysis. An additional aim was to correlate the ADC values and histological tumor grades.MethodsThe prospective study included 119 female patients with or without vaginal bleeding and pathological values of endometrial thickness, who underwent MRI examinations. According to MRI reports the patients were divided into 45 suspicious malignant and 74 suspicious benign endometrial lesions. The radiological diagnosis was compared to the histopathological evaluation, which confirmed 37 malignant lesions while the rest were benign.ResultsThe mean ADC value for malignant lesions was 0.761 ± 0.13×10−3 mm2/s and for benign lesions was 1.318 ± 0.20×10−3 mm2/s. The ADC values for malignant lesions were expectedly lower than those of benign lesions (p<0.001). The ADC cut-off value was 1.007×10−3 mm2/s with a sensitivity of 100%, specificity of 92.7%, a positive predictive value of 60.3%, and a negative predictive value of 100%. In comparison with the histopathological findings, the sensitivity of MRI was 100%, specificity 90.2%, positive predictive value was 82.2%, and negative predictive value was 100%. Observing the histological grades 1, 2, and 3 of endometrial carcinoma, no statistically significant differences of mean ADC values were found. The mean ADC values for histological tumor grades 1,2 and 3 were 0.803 ± 0.13×10−3 mm2/s, 0.754 ± 0.12×10−3 mm2/s and 0.728 ± 0.13×10−3 mm2/s, respectively.ConclusionDWI and ADC values represent clinically useful tools for the differentiation between malignant and benign endometrial lesions with high sensitivity and good specificity, but the results failed to demonstrate their usefulness in differentiating histological grades of endometrial cancer.

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“…The apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) can reflect the malignancy of the tumor, which has been proved to be valuable in the diagnosis, typing and grade of EC [ 10 – 12 ]. Gharibvand et al [ 11 ]. reported that DWI sequence (ADC value) had high accuracy in diagnosing benign endometrial lesions and differentiating malignant lesions.…”

Section: Introductionmentioning

confidence: 99%

MRI-based radiomics and ADC values are related to recurrence of endometrial carcinoma: a preliminary analysis

et al. 2021

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Background To identify predictive value of apparent diffusion coefficient (ADC) values and magnetic resonance imaging (MRI)-based radiomics for all recurrences in patients with endometrial carcinoma (EC). Methods One hundred and seventy-four EC patients who were treated with operation and followed up in our institution were retrospectively reviewed, and the patients were divided into training and test group. Baseline clinicopathological features and mean ADC (ADCmean), minimum ADC (ADCmin), and maximum ADC (ADCmax) were analyzed. Radiomic parameters were extracted on T2 weighted images and screened by logistic regression, and then a radiomics signature was developed to calculate the radiomic score (radscore). In training group, Kaplan–Meier analysis was performed and a Cox regression model was used to evaluate the correlation between clinicopathological features, ADC values and radscore with recurrence, and verified in the test group. Results ADCmean showed inverse correlation with recurrence, while radscore was positively associated with recurrence. In univariate analyses, FIGO stage, pathological types, myometrial invasion, ADCmean, ADCmin and radscore were associated with recurrence. In the training group, multivariate Cox analysis showed that pathological types, ADCmean and radscore were independent risk factors for recurrence, which were verified in the test group. Conclusions ADCmean value and radscore were independent predictors of recurrence of EC, which can supplement prognostic information in addition to clinicopathological information and provide basis for individualized treatment and follow-up plan.

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The diagnostic precision of apparent diffusion coefficient (ADC) in grading of malignant endometrial lesions compared with histopathological findings

Cited by 8 publications

References 22 publications

The value of dynamic contrast-enhanced MRI and diffusion-weighted sequence in the evaluation of endometrial lesions

The value of dynamic contrast-enhanced MRI and diffusion-weighted sequence in the evaluation of endometrial lesions

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

MRI-based radiomics and ADC values are related to recurrence of endometrial carcinoma: a preliminary analysis

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