Jingya Chen1, Weimin Fan2, Hailei Gu3, Yaohui Wang4, Yuting Liu5, Xiao Chen1, Shuai Ren1, Zhongqiu Wang1. 1. Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, PR China. 2. Department of Clinical Laboratory, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, Jiangsu Province, PR China. 3. Department of Radiology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, Jiangsu Province, PR China. 4. Department of Pathology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, PR China. 5. Department of Pathology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, PR China.
Abstract
BACKGROUND: Diagnostic type II endometrial carcinoma (EC) is considered more aggressive and has a poorer prognosis than type I EC; differentiation between them is helpful for preoperative clinical decision-making. However, the diagnostic value of the apparent diffusion coefficient (ADC) in differentiating them remains unclear. PURPOSE: To investigate the value of ADC in differentiating type II EC from type I EC. MATERIAL AND METHODS: Ninety-four patients with EC who underwent diffusion-weighted imaging (DWI) were retrospectively included and divided into type I and type II subgroups, based on the postoperative pathologic results. We analyzed the clinical characteristics, conventional magnetic resonance imaging manifestations, and ADC mean values (ADCmean), ADC minimum values (ADCmin), and ADC max values (ADCmax). Receiver operating characteristic (ROC) curve analysis was further used to assess the predictive performance. RESULTS: The ADCmean, ADCmin, and tumor size differed significantly between the two subtypes. The area under the ROC curve (AUC) for ADCmean and ADCmin was 0.787 (95% confidence interval [CI] = 0.692-0.88) and 0.835 (95% CI = 0.751-0.919) for predicting type II EC, respectively. The optimal cut-off value of ADCmean for prediction was 0.757 × 10-3 mm2/s with a sensitivity of 91%, a specificity of 58%, and an accuracy of 74%, while for ADCmin was 0.637 × 10-3 mm2/s with a sensitivity of 82%, a specificity of 73%, and an accuracy of 75%. CONCLUSION: EC with lower ADCmean and ADCmin values derived from DWI, and a larger size, are indicative of type II EC.
BACKGROUND: Diagnostic type II endometrial carcinoma (EC) is considered more aggressive and has a poorer prognosis than type I EC; differentiation between them is helpful for preoperative clinical decision-making. However, the diagnostic value of the apparent diffusion coefficient (ADC) in differentiating them remains unclear. PURPOSE: To investigate the value of ADC in differentiating type II EC from type I EC. MATERIAL AND METHODS: Ninety-four patients with EC who underwent diffusion-weighted imaging (DWI) were retrospectively included and divided into type I and type II subgroups, based on the postoperative pathologic results. We analyzed the clinical characteristics, conventional magnetic resonance imaging manifestations, and ADC mean values (ADCmean), ADC minimum values (ADCmin), and ADC max values (ADCmax). Receiver operating characteristic (ROC) curve analysis was further used to assess the predictive performance. RESULTS: The ADCmean, ADCmin, and tumor size differed significantly between the two subtypes. The area under the ROC curve (AUC) for ADCmean and ADCmin was 0.787 (95% confidence interval [CI] = 0.692-0.88) and 0.835 (95% CI = 0.751-0.919) for predicting type II EC, respectively. The optimal cut-off value of ADCmean for prediction was 0.757 × 10-3 mm2/s with a sensitivity of 91%, a specificity of 58%, and an accuracy of 74%, while for ADCmin was 0.637 × 10-3 mm2/s with a sensitivity of 82%, a specificity of 73%, and an accuracy of 75%. CONCLUSION: EC with lower ADCmean and ADCmin values derived from DWI, and a larger size, are indicative of type II EC.
Entities:
Keywords:
Apparent diffusion coefficient; endometrial carcinoma; type I endometrial carcinoma; type II endometrial carcinoma