الفهرس | Only 14 pages are availabe for public view |
Abstract EC is the most common gynecological cancer in developed countries with increased incidence globally.DWI is a functional imaging technique used to show tissue characteristics. It depends on the fact that water molecules can diffuse freely in low cellular environment, while tissue hyper cellularity causes its restriction, a phenomenon called ‛Brownian motion’. As a result, malignant tumors due to its hyper cellular nature show restriction of diffusion DWI enables quantitative information to be obtained with the use of ADC maps to calculate degree of diffusion. We investigated the role of qualitative and quantitative DWI evaluation in the preoperative prediction of deep myometrial invasion, CSI, LVSI, lymph node metastases and grading of endometrial malignancy in comparison to the histopathological findings.Our prospective study which conducted on 68 cases of EC and showed that addition of DW- ADC to the conventional MRI increased the diagnostic performance.In our study, we considered DWI with b value =1000 to search for the presence of areas with higher signal intensity. High SI of lesion on DWI was observed all cases with hypointensity in the corresponding ADC maps (restricted diffusion ) .There was a statistically significant negative correlation between ADC values and tumor grade (strong association), and FIGO stage (medium strength of association)There was a statistically significantly lower ADC values in those with deep MI, CSI ,LVSI, LN metastasis and Type II EC .Our study confirmed the high diagnostic performance of MRI in the preoperative assessment of endometrial cancer. The combination of DWI and morphological T2WI demonstrated superior diagnostic accuracy in the assessment of the depth of myometrial invasion when compared with that of CE-MRI and T2WI, indicating that DWI+T2WI is a potential replacement for DCE-MRI in the preoperative staging of endometrial cancer, especially for patients in whom contrast agents are contraindicated.DWI when combined with ADC measurements provides good information for preoperative evaluation of endometrial cancer that enables accurate treatment decisions and surgical planning. Relatively small number of non-endometrioid EC were included in the study. ADC measurements can be affected by the size, shape, and location of ROI. selection of the area in the tumor can be subjective and might cause some bias. Single Centre study. Recommendations: Further study with large number of non-endometrioid cases.. |