Application of diffusion-weighted MRI for endometrial cancer diagnosis

Objective: To investigate the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) for the diagnosis of endometrial cancer and to verify the feasibility of apparent diffusion coefficient (ADC) values to distinguish normal and endometrial cancer. Material and Methods: There were 24 patients with confirmed endometrial cancer enrolled into this study and underwent preoperative MRI and total hysterectomy. Twenty-two healthy volunteers were included as control. The apparent diffusion coefficient of endometrial cancer and normal endometrium were measured on the apparent diffusion coefficient map of each diffusion-weighted image and compared. The differences among the ADC values of normal endometrium, junctional zone, and endometrium were compared as well. Results: The ADC values of the 22 control groups were as follows: myometrium (1.50±0.08)×10-3 mm 2/s, junctional zone (0.95±0.08)×10-3 mm 2/s, and endometrium (1.33±0.09)×10-3 mm 2/s. The ADC values of endometrial cancer (0.77±0.08)×10-3 mm2/s was much lower than that of normal endometrium (p < 0.001). The mean ADC value for each histologic grade was 0.90±0.11(G1), 0.89±0. 3 (G2), and 0.69±0.09 (G3). The ADC value of grade 3 tumors was significantly lower than that of grade 1 tumors (p < 0.05). There was a statistically significant difference among the ADC between cancer group and healthy individuals. Conclusion: The DW-MRI provides helpful information for evaluation of endometrial cancer.

Apparent diffusion coefficient; Cancer; Diffusion-weighted imaging; MRI; Uterus.

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