MR diffusion imaging in preoperative evaluation of depth of myometrial invasion in endometrial carcinoma

ObjectiveTo investigate the accuracy of high b value Diffusion Weighted Imaging (DWI) combined with T2-WI in estimating the depth of myometrial invasion in endometrial carcinoma compared to the accuracy of post contrast MRI.Subjects and methodsTwenty-seven patients with histologically proven endometrial carcinoma were enrolled in this study. T2-weighted, post contrast T1-weighted after 30, 60, 120 s, and DWI with b values of 0, 500 and 1000 s/mm2 were obtained. The Depth of myometrial invasion was assessed. The ADC values were measured and correlated with the depth of myometrial invasion and with the histological grade.ResultsThe high b value DWI showed similar sensitivity and higher specificity in evaluating the depth of myometrial invasion compared to the post contrast MRI. No correlation was found between the ADC values and the depth of myometrial invasion. No correlation was found between the ADC values and the histologic tumor grade.ConclusionDW-MRI has a high diagnostic efficacy comparable to that of post contrast study, making it a good alternative in preoperative evaluation of depth of myometrial invasion in endometrial carcinoma patients. DW-MRI thus should be considered part of the routine pre-operative pelvic MRI in this group of patients.