6. The role of diffusion-weighted magnetic resonance imaging in the preoperative assessment of histological grade in endometrial carcinoma

Nguyen Van Thi, Tran Thi Ha Trang, Duong Duc Huu

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Abstract

The purpose of our study was to determine the role of quantitative diffusion-weighted magnetic resonance imaging in preoperative predicting the histological grade of endometrioid endometrial carcinoma (EC). A cross-sectional descriptive study was conducted on 57 endometrioid endometrial carcinoma patients from January 2022 to May 2023 at the National Cancer Hospital. The mean age was 60.4 ± 10.16. Histological grades 1, 2, and 3 tumors had a prevalence of 45.6%, 36.8%, and 17.5%, respectively. The mean ADC value was 0.723 x 10-3 mm2/s. The mean ADC values of endometrioid EC grade 1, grade 2, and grade 3 are 0.738, 0.716, and 0.698 (x 10-3 mm2/s), respectively, p < 0.05. Using the ROC curve analysis in diagnosing grade 1 and grade 3 endometrial cancer gives the area under the curve AUC of 0.791 and 0.823, respectively. The threshold for diagnosing grade 1 endometrioid EC is 0.7295 x 10-3 mm2/s, with a sensitivity and specificity of 61.5% and 90.3%. The threshold for diagnosing grade 3 endometrioid EC is 0.7185 x 10-3 mm2/s, with a sensitivity and specificity of 100% and 59.6%. 

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References

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. May 2021;71(3):209-249. doi:10.3322/caac.21660
2. Cree IA, White VA, Indave BI, et al. Revising the WHO classification: female genital tract tumours. Histopathology. Jan 2020;76(1):151-156. doi:10.1111/his.13977
3. Batista TP, Cavalcanti CL, Tejo AA, et al. Accuracy of preoperative endometrial sampling diagnosis for predicting the final pathology grading in uterine endometrioid carcinoma. Eur J Surg Oncol. Sep 2016;42(9):1367-71. doi:10.1016/j.ejso.2016.03.009
4. Ben-Shachar I, Pavelka J, Cohn DE, et al. Surgical staging for patients presenting with grade 1 endometrial carcinoma. Obstet Gynecol. Mar 2005;105(3):487-93. doi:10.1097/01.AOG. 0000149151.74863.c4
5. Berek JS, Matias-Guiu X, Creutzberg C, et al. FIGO staging of endometrial cancer: 2023. Int J Gynaecol Obstet. Aug 2023;162(2):383-394. doi:10.1002/ijgo.14923
6. Trần Thị Huệ. Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ 1.5 Tesla trong phân loại giai đoạn ung thư nội mạc tử cung theo FIGO 2009. Trường Đại học Y Hà Nội; 2020.
7. Oaknin A, Bosse TJ, Creutzberg CL, et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. Sep 2022;33(9):860-877. doi:1 0.1016/j.annonc.2022.05.009
8. Amant F, Moerman P, Neven P, et al. Endometrial cancer. Lancet. Aug 6-12 2005;366(9484):491-505. doi:10.1016/S0140-6736(05)67063-8
9. Nougaret S, Reinhold C, Alsharif SS, et al. Endometrial Cancer: Combined MR Volumetry and Diffusion-weighted Imaging for Assessment of Myometrial and Lymphovascular Invasion and Tumor Grade. Radiology. Sep 2015;276(3):797-808. doi:10.1148/radiol.15141212
10. Rechichi G, Galimberti S, Signorelli M, et al. Endometrial cancer: correlation of apparent diffusion coefficient with tumor grade, depth of myometrial invasion, and presence of lymph node metastases. AJR Am J Roentgenol. Jul 2011;197(1):256-62. doi:10.2214/AJR.10.5584
11. Gil RT, Cunha TM, Horta M, et al. The added value of diffusion-weighted imaging in the preoperative assessment of endometrial cancer. Radiol Bras. Jul-Aug 2019;52(4):229-236. doi:10.1590/0100-3984.2018.0054
12. Tamai K, Koyama T, Saga T, et al. Diffusion-weighted MR imaging of uterine endometrial cancer. J Magn Reson Imaging. Sep 2007;26(3):682-7. doi:10.1002/jmri.20997
13. Bakir VL, Bakir B, Sanli S, et al. Role of diffusion-weighted MRI in the differential diagnosis of endometrioid and non-endometrioid cancer of the uterus. Acta Radiol. Jun 2017;58(6):758-767. doi:10.1177/ 0284185116669873
14. Tanaka T, Terai Y, Fujiwara S, et al. Preoperative diffusion-weighted magnetic resonance imaging and intraoperative frozen sections for predicting the tumor grade in endometrioid endometrial cancer. Oncotarget. Nov 27 2018;9(93):36575-36584. doi:10.18632/oncotarget.26366
15. Bharwani N, Miquel ME, Sahdev A, et al. Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer. Br J Radiol. Nov 2011;84(1007):997-1004. doi:10.1259/bjr/14980811
16. Blazic I, Maksimovic R, Gajic M, et al. Apparent diffusion coefficient measurement covering complete tumor area better predicts rectal cancer response to neoadjuvant chemoradiotherapy. Croat Med J. Oct 2015;56(5):460-9. doi:10.3325/cmj.2015.56.460