Takashi Ota1, Masatoshi Hori2, Hiromitsu Onishi1, Makoto Sakane1, Takahiro Tsuboyama1, Mitsuaki Tatsumi1, Atsushi Nakamoto3, Tadashi Kimura4, Yoshifumi Narumi3, Noriyuki Tomiyama1. 1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. mhori@radiol.med.osaka-u.ac.jp. 3. Department of Radiology, Osaka Medical College, Osaka, Japan. 4. Department of Obstetrics and Gynaecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Abstract
OBJECTIVES: To compare the image quality and diagnostic performance of reduced field-of-view (rFOV) versus conventional full field-of-view (fFOV) diffusion-weighted (DW) imaging of endometrial cancer. METHODS: Fifty women with endometrial cancer underwent preoperative rFOV and fFOV DW imaging. Two radiologists compared the image qualities of both techniques, and five radiologists assessed superficial and deep myometrial invasion using both techniques. The statistical analysis included the Wilcoxon signed-rank test and paired t-test for comparisons of image quality and mean diagnostic values. RESULTS: Distortion, tumour delineation, and overall image quality were significantly better with rFOV DW imaging, compared to fFOV DW imaging (P < 0.05); however, the former was inferior in noise (P < 0.05). Regarding superficial invasion, the mean accuracies of the techniques did not differ statistically (rFOV, 58.0% versus fFOV, 56.0%; P = 0.30). Regarding deep myometrial invasion, rFOV DW imaging yielded significantly better mean accuracy, specificity, and positive predictive values (88.4%, 97.8%, and 91.7%, respectively), compared with fFOV DW imaging (84.8%, 94.1%, and 77.4%, respectively; P = 0.009, 0.005, and 0.011, respectively). CONCLUSIONS: Compared with fFOV DW imaging, rFOV DW imaging yielded less distortion, improved image quality and, consequently, better diagnostic performance for deep myometrial invasion of endometrial cancer. KEY POINTS: • rFOV DWI yields better assessment of deep myometrial invasion in endometrial cancer. • rFOV DWI could not sufficiently evaluate superficial invasion in endometrial cancer. • Distortion, tumour delineation, and overall image quality were improved with rFOV DWI.
OBJECTIVES: To compare the image quality and diagnostic performance of reduced field-of-view (rFOV) versus conventional full field-of-view (fFOV) diffusion-weighted (DW) imaging of endometrial cancer. METHODS: Fifty women with endometrial cancer underwent preoperative rFOV and fFOV DW imaging. Two radiologists compared the image qualities of both techniques, and five radiologists assessed superficial and deep myometrial invasion using both techniques. The statistical analysis included the Wilcoxon signed-rank test and paired t-test for comparisons of image quality and mean diagnostic values. RESULTS: Distortion, tumour delineation, and overall image quality were significantly better with rFOV DW imaging, compared to fFOV DW imaging (P < 0.05); however, the former was inferior in noise (P < 0.05). Regarding superficial invasion, the mean accuracies of the techniques did not differ statistically (rFOV, 58.0% versus fFOV, 56.0%; P = 0.30). Regarding deep myometrial invasion, rFOV DW imaging yielded significantly better mean accuracy, specificity, and positive predictive values (88.4%, 97.8%, and 91.7%, respectively), compared with fFOV DW imaging (84.8%, 94.1%, and 77.4%, respectively; P = 0.009, 0.005, and 0.011, respectively). CONCLUSIONS: Compared with fFOV DW imaging, rFOV DW imaging yielded less distortion, improved image quality and, consequently, better diagnostic performance for deep myometrial invasion of endometrial cancer. KEY POINTS: • rFOV DWI yields better assessment of deep myometrial invasion in endometrial cancer. • rFOV DWI could not sufficiently evaluate superficial invasion in endometrial cancer. • Distortion, tumour delineation, and overall image quality were improved with rFOV DWI.
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