Influence of menopausal status on diagnostic accuracy of myometrial invasion in endometrial cancer: Diffusion-weighted and dynamic contrast-enhanced MRI at 3 T

G. Lin, Y. T. Huang, A. Chao, K. K. Ng, L. Y. Yang, S. H. Ng*, C. H. Lai

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

12 Scopus citations

Abstract

Aim To assess the influence of menopausal status on the diagnostic accuracy of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for evaluating myometrial invasion in patients diagnosed with endometrial cancer. Materials and methods In this prospective study, 91 consecutive female patients diagnosed with endometrial cancer were enrolled for preoperative evaluation using 3 T MRI. Two radiologists interpreted myometrial invasion depth on DW (b=1000 s/mm2) and DCE MRI images, with surgical histopathology as the reference standard. Statistical methods included kappa statistics for evaluating reader agreement and diagnostic performance analysis between pre- and postmenopausal groups. Results Reader agreement of DW MRI was poor (κ=0.20) for premenopausal patients. The diagnostic accuracy of DW MRI in detecting myometrial involvement was significantly lower in premenopausal compared with postmenopausal patients (0.42 versus 0.73, p=0.006). There was no difference in the diagnostic accuracy of DW MRI in detecting deep myometrial invasion between premenopausal and postmenopausal groups (0.94 versus 0.95, p>0.99). Conclusion For premenopausal patients who plan to receive fertility-preserving treatment for endometrial cancer, DCE MRI is superior to DW MRI in excluding any possible myometrial invasion. For preoperative assessment of deep myometrial invasion, DW MRI can be a legitimate alternative to DCE MRI regardless of menopausal status and is particularly beneficial for patients at risk of nephrogenic systemic fibrosis.

Original languageEnglish
Pages (from-to)1260-1268
Number of pages9
JournalClinical Radiology
Volume70
Issue number11
DOIs
StatePublished - 01 11 2015

Bibliographical note

Publisher Copyright:
© 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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