The usefulness of diffusion-weighted MRI in the differentiation between focal uterine endometrial soft tissue lesions

Abstract

Background: Several endometrial conditions may be challenging for radiologists due to the overlap of imaging features and variable endometrial pathologies. MRI with DWI is the most commonly used imaging technique for the diagnosis and characterization of endometrial focal lesions. Results: The 50 studied lesions were classified according to their histopathological results into the benign group (28 lesions, 56%) and the malignant group (22 lesions, 44%). Conventional MRI could correctly diagnose 39 of the 50 lesions (22/28 benign and 17/22 malignant lesions), achieving a sensitivity of 77.27%, specificity of 78.56%, accuracy of 78%, predictive positive value (PPV) of 73.91%, and negative positive value (NPV) of 81.48%. By combining DWI and apparent diffusion coefficient (ADC) value mapping at a high b value (b = 1000) in MRI, we could correctly diagnose 47 of the 50 lesions (26/28 benign and 21/22 malignant lesions), with increased sensitivity (95.45%), specificity (92.86%), accuracy (94%), PPV (91.3%), and NPV (96%). Conclusion: Combining DWI with ADC mapping at a high b value in pelvic MRI examination is valuable in differentiating endometrial focal lesions with increased diagnostic sensitivity, specificity, and accuracy. Aim of the work: This study aimed to evaluate the role of DWI in the diagnosis and differential diagnosis of benign and malignant focal endometrial masses.

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

“…Malignant lesions also appear dense in DWI because water molecules cannot pass through their enhanced cellularity. These findings were almost identical to those mentioned by Mansour et al 10 Endometrial sarcoma had the lowest ADC value (0.5 x 10 -3 ) in presented study, followed by carcinoma consistent with Fujii et al findings. 11 Qualitative parameters of dynamic contrast-enhanced MRI can be easily applied in daily practice and reflect the kinetic properties of the lesion which include the enhancement curves.…”

Diffusion-weighted Imaging in the Benign-malignant Differentiation of Endometrial Pathologies; Effectiveness of Visual Evaluation

“…Many promising studies have been published recently in the differentiation of benign and malignant endometrial pathologies using DWI. [5][6][7][8][11][12][13][14][15][16][17][18] In the present study, the authors evaluated various endometrial pathologies quantitatively on the ADC map and visually on DWI-ADC.…”