Diffusion-Weighted MR Imaging of Uterine Endometrial Cancer

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Purpose:To determine the feasibility of diffusion-weighted (DW) MRI of uterine endometrial cancer and to investigate whether the apparent diffusion coefficient (ADC) values of endometrial cancer differ from those of normal endometrium and whether they differ according to the histologic grade of the tumor.Materials and Methods:Study population included 18 consecutive females with surgically proven endometrial cancer and 12 females with pathologically confirmed normal endometrium in cervical cancer patients. Visual evaluation and ADC measurement were performed in endometrial cancer and normal endometrium.Results:All endometrial cancer and the normal endometrium appeared hyperintense on DW images. The mean ADC value (10−3 mm2/second) of endometrial cancer was 0.88 ± 0.16, which was significantly lower (P < 0.01) than that of normal endometrium (1.53 ± 0.10). The mean ADC value for each histologic grade was 0.93 ± 0.16 (G1), 0.92 ± 0.13 (G2), and 0.73 ± 0.09 (G3).Conclusion:The present study showed that DW imaging is feasible in demonstrating uterine endometrial cancer and ADC measurement has a potential ability to differentiate between normal and cancerous tissue of the endometrium. The ADC values of endometrial cancers of higher grade show tendency to decrease compared to those of lower grade, although estimation of histologic grade based on ADC values seems difficult because of considerable overlap.

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