Diagnostic Comparison of MRI Sequences for Assessing Myometrial Invasion in Endometrial Cancer: A 1.5T MRI Study

Ahmet Akçay

Makale detayları

Diagnostic Comparison of MRI Sequences for Assessing Myometrial Invasion in Endometrial Cancer: A 1.5T MRI Study

Yazarlar:

Ahmet Akçay

Yayıncı:

Hitit University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Hitit Medical Journal Vol.7 Issue 1, pp.29-36

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341688

pISSN:

2687-4717

Anahtar kelimeler:

Özet:

 Objective: To compare the diagnostic accuracy of T2-weighted, dynamic contrast-enhanced imaging, and diffusion-weighted imaging in assessing myometrial invasion depth in endometrial cancer and to determine if any sequence performs better. Material and Method: In this retrospective study, 98 patients with histopathologically confirmed endometrial cancer underwent preoperative multiparametric pelvic magnetic resonance imaging scans using a 1.5-T machine between January 2018 and May 2024. The T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging sequences were independently reviewed by an experienced radiologist blinded to pathology results to assess myometrial invasion depth superficial vs. deep. Sensitivity, specificity, accuracy, negative predictive value, and positive predictive value were calculated. Statistical analyses included ROC curves and McNemars test. Results: T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging showed high diagnostic accuracy for assessing myometrial invasion, with area under the curve values of 0.967, 0.954, and 0.916, respectively. T2-weighted images achieved the highest sensitivity 1.0 and specificity 0.934. While diffusion-weighted images and dynamic contrast-enhanced images demonstrated slightly lower accuracy compared to T2-weighted images, the differences were not statistically significant p0.05. However, both diffusion-weighted images and dynamic contrast-enhanced images had higher misclassification rates in cases with fibroids, adenomyosis, or indistinct junctional zones. Conclusion: All three magnetic resonance sequences demonstrated high diagnostic accuracy for evaluating myometrial invasion in EC. Although T2-weighted images had slightly better diagnostic accuracy due to its superior anatomical detail, the differences were not statistically significant. In cases with confounding factors, combining T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging improves diagnostic reliability.

 Objective: To compare the diagnostic accuracy of T2-weighted, dynamic contrast-enhanced imaging, and diffusion-weighted imaging in assessing myometrial invasion depth in endometrial cancer and to determine if any sequence performs better. Material and Method: In this retrospective study, 98 patients with histopathologically confirmed endometrial cancer underwent preoperative multiparametric pelvic magnetic resonance imaging scans using a 1.5-T machine between January 2018 and May 2024. The T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging sequences were independently reviewed by an experienced radiologist blinded to pathology results to assess myometrial invasion depth superficial vs. deep. Sensitivity, specificity, accuracy, negative predictive value, and positive predictive value were calculated. Statistical analyses included ROC curves and McNemars test. Results: T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging showed high diagnostic accuracy for assessing myometrial invasion, with area under the curve values of 0.967, 0.954, and 0.916, respectively. T2-weighted images achieved the highest sensitivity 1.0 and specificity 0.934. While diffusion-weighted images and dynamic contrast-enhanced images demonstrated slightly lower accuracy compared to T2-weighted images, the differences were not statistically significant p0.05. However, both diffusion-weighted images and dynamic contrast-enhanced images had higher misclassification rates in cases with fibroids, adenomyosis, or indistinct junctional zones. Conclusion: All three magnetic resonance sequences demonstrated high diagnostic accuracy for evaluating myometrial invasion in EC. Although T2-weighted images had slightly better diagnostic accuracy due to its superior anatomical detail, the differences were not statistically significant. In cases with confounding factors, combining T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging improves diagnostic reliability.

 Objective: To compare the diagnostic accuracy of T2-weighted, dynamic contrast-enhanced imaging, and diffusion-weighted imaging in assessing myometrial invasion depth in endometrial cancer and to determine if any sequence performs better. Material and Method: In this retrospective study, 98 patients with histopathologically confirmed endometrial cancer underwent preoperative multiparametric pelvic magnetic resonance imaging scans using a 1.5-T machine between January 2018 and May 2024. The T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging sequences were independently reviewed by an experienced radiologist blinded to pathology results to assess myometrial invasion depth superficial vs. deep. Sensitivity, specificity, accuracy, negative predictive value, and positive predictive value were calculated. Statistical analyses included ROC curves and McNemars test. Results: T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging showed high diagnostic accuracy for assessing myometrial invasion, with area under the curve values of 0.967, 0.954, and 0.916, respectively. T2-weighted images achieved the highest sensitivity 1.0 and specificity 0.934. While diffusion-weighted images and dynamic contrast-enhanced images demonstrated slightly lower accuracy compared to T2-weighted images, the differences were not statistically significant p0.05. However, both diffusion-weighted images and dynamic contrast-enhanced images had higher misclassification rates in cases with fibroids, adenomyosis, or indistinct junctional zones. Conclusion: All three magnetic resonance sequences demonstrated high diagnostic accuracy for evaluating myometrial invasion in EC. Although T2-weighted images had slightly better diagnostic accuracy due to its superior anatomical detail, the differences were not statistically significant. In cases with confounding factors, combining T2-weighted, dynamic contrast-enhanced, and diffusion-weighted imaging improves diagnostic reliability.

 Amaç: T2 ağırlıklı, dinamik kontrastlı görüntüleme ve difüzyon ağırlıklı görüntüleme tekniklerinin endometrial kanserde miyometrial invazyon derinliğini değerlendirmedeki tanısal doğruluğunu karşılaştırmak ve herhangi bir dizinin daha iyi performans gösterip göstermediğini belirlemektir. Gereç ve Yöntem: Bu retrospektif çalışmada, Ocak 2018 ile Mayıs 2024 tarihleri arasında histopatolojik olarak doğrulanmış endometrium kanseri tanısı konulan 98 hastaya preoperatif multiparametrik pelvik manyetik rezonans görüntülemeleri yapıldı. T2 Ağırlıklı, dinamik kontrastlı ve difüzyon ağırlıklı görüntüleme dizileri, patoloji sonuçlarından habersiz deneyimli bir radyolog tarafından bağımsız olarak incelenerek miyometrial invazyon derinliği yüzeyel veya derin değerlendirildi. Duyarlılık, özgüllük, doğruluk, negatif prediktif değer ve pozitif prediktif değer hesaplandı. İstatistiksel analizler ROC eğrileri ve McNemar testi ile yapıldı. Bulgular: T2 Ağırlıklı, dinamik kontrastlı ve difüzyon ağırlıklı görüntüleme dizileri, miyometrial invazyonun değerlendirilmesinde yüksek tanısal doğruluk gösterdi; eğri altındaki alan değerleri sırasıyla 0,967, 0,954 ve 0,916 olarak bulundu. T2 Ağırlıklı seri, en yüksek duyarlılık 1,0 ve özgüllük 0,934 değerlerine ulaştı. Difüzyon ağırlıklı görüntüleme ve dinamik kontrastlı görüntüleme, T2 Ağırlıklı seriye kıyasla daha düşük doğruluk gösterdi, ancak aradaki fark istatistiksel olarak anlamlı değildi p0,05. Bununla birlikte, Difüzyon ağırlıklı görüntüleme ve dinamik kontrastlı görüntülemede, fibroid, adenomyozis veya belirsiz junctional zone gibi karışıklığa neden olan faktörler daha fazla yanlış sınıflandırmaya yol açmıştır. Sonuç: Üç manyetik rezonans dizisi de endometrium kanserinde miyometrial invazyonun değerlendirilmesinde yüksek tanısal doğruluk göstermiştir. Daha fazla anatomik detay sunan T2 Ağırlıklı serinin, daha yüksek tanısal doğruluk sağladığı gözlemlenmiş; ancak diğer sekanslarla istatistiksel olarak anlamlı fark saptanmamıştır. Karışıklığa neden olan durumlarda, T2 Ağırlıklı serinin difüzyon ağırlıklı görüntüleme ve dinamik kontrastlı görüntüleme ile birlikte değerlendirilmesi tanısal doğruluğu artırmak için önerilmektedir.

Makale detayları

Diagnostic Comparison of MRI Sequences for Assessing Myometrial Invasion in Endometrial Cancer: A 1.5T MRI Study

Yazarlar:

Ahmet Akçay

Yayıncı:

Hitit University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Hitit Medical Journal Vol.7 Issue 1, pp.29-36

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341688

pISSN:

2687-4717

Endometrial cancer

MRI

myometrial invasionEndometrial kanser

MRG

miyometrial invazyon

Sayı

Makale detayları

Diagnostic Comparison of MRI Sequences for Assessing Myometrial Invasion in Endometrial Cancer: A 1.5T MRI Study

Yazarlar: Ahmet Akçay

Yayıncı: Hitit University

Ana Başlıklar: Radyoloji ve Organ Görüntüleme

Dergi: Hitit Medical Journal Vol.7 Issue 1, pp.29-36

Belge Tipi: Makale

Yayın Tarihi: 2/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001341688

pISSN: 2687-4717

Endometrial cancer

MRI

myometrial invasionEndometrial kanser

MRG

miyometrial invazyon

Sayı

Yazarlar:

Ahmet Akçay

Yayıncı:

Hitit University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Hitit Medical Journal Vol.7 Issue 1, pp.29-36

Belge Tipi:

Makale

Yayın Tarihi:

2/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001341688

pISSN:

2687-4717