Evaluating Myometrial Invasion in Endometrial Cancer: Comparison of Reduced Field-of-view Diffusion-weighted Imaging and Dynamic Contrast-enhanced MR Imaging

Mayumi Takeuchi, Kenji Matsuzaki, Masafumi Harada
Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2017 · vol. 17(1) , pp. 28–34 · doi:10.2463/mrms.mp.2016-0128 · PMID:28515411 · PMC5760230 · W2614577358
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Reduced field-of-view diffusion-weighted MR imaging may improve myometrial invasion staging accuracy for endometrial cancer, especially with coexisting adenomyosis, and can serve as a contrast-free alternative to dynamic contrast-enhanced imaging.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This retrospective study compared reduced field-of-view diffusion-weighted (DW) MRI with 3D dynamic contrast-enhanced (DCE) MRI for assessing the depth of myometrial invasion in 25 women with surgically proven endometrial cancer, using T2-weighted imaging plus reduced FOV DW and 3D DCE sequences in sagittal and oblique axial planes. Tumor invasion depth (stage S <50% vs stage D ≥50%) on MRI was correlated with surgical pathology, with diagnostic accuracy of 68% for T2-weighted imaging, 92% for 3D DCE, and 96% for reduced FOV DW. In two patients with coexisting adenomyosis, T2-weighted imaging and 3D DCE failed to show deep invasion, whereas reduced FOV DW clearly demonstrated the tumor margin; combining reduced FOV DW with T2 improved accuracy to up to 100%. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis is a cited coexisting condition affecting MRI performance in evaluating myometrial invasion in endometrial cancer.

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Abstract

PURPOSE: To compare the diagnostic ability of reduced FOV diffusion-weighted (DW) MR imaging with that of 3D dynamic contrast-enhanced (DCE) MR imaging in evaluating the depth of myometrial invasion in patients with endometrial cancer. METHODS: -weighted imaging, reduced FOV DW imaging and 3D DCE MR imaging in sagittal and oblique axial (short axis) planes in 25 women with surgically proven endometrial cancer were retrospectively evaluated. The depth of myometrial invasion (stage S: < 50% vs stage D: ≥ 50%) on MR imaging was correlated with surgical pathology results. RESULTS: -weighted imaging improved the assessment of myometrial invasion with a diagnostic accuracy of up to 100%. CONCLUSIONS: Addition of reduced FOV DW imaging may improve the staging accuracy of MR imaging for endometrial cancer in assessing the depth of myometrial invasion. Especially, reduced FOV DW imaging has an advantage in assessing the depth of myometrial invasion for patients with coexisting adenomyosis. Reduced FOV DW imaging can be an alternative to 3D DCE MR imaging in evaluating myometrial invasion of endometrial cancer without the use of contrast medium.
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Keywords

endometrial cancer, magnetic resonance imaging, diffusion-weighted magnetic resonance imaging, dynamic contrast-enhanced-magnetic resonance imaging, reduced field-of-view 2018 Volume 17 Issue 1 Pages 28-34 Details

Abstract

Purpose: To compare the diagnostic ability of reduced FOV diffusion-weighted (DW) MR imaging with that of 3D dynamic contrast-enhanced (DCE) MR imaging in evaluating the depth of myometrial invasion in patients with endometrial cancer.

Methods

Three tesla MR images including T2-weighted imaging, reduced FOV DW imaging and 3D DCE MR imaging in sagittal and oblique axial (short axis) planes in 25 women with surgically proven endometrial cancer were retrospectively evaluated. The depth of myometrial invasion (stage S: < 50% vs stage D: ≥ 50%) on MR imaging was correlated with surgical pathology results.

Results

The 25 endometrial cancers included 16 stage S and 9 stage D tumors. The depth of myometrial invasion could be accurately evaluated in 68% of the cases for T2-weighted imaging, 92% for 3D DCE MR imaging, and 96% for reduced FOV DW imaging. In two patients with coexisting adenomyosis, both T2-weighted imaging and 3D DCE MR imaging failed to reveal the deep myometrial invasion, and reduced FOV DW imaging clearly demonstrated the tumor margin in the cases. Combination of reduced FOV DW imaging reading together with T2-weighted imaging improved the assessment of myometrial invasion with a diagnostic accuracy of up to 100%.

Conclusions

Addition of reduced FOV DW imaging may improve the staging accuracy of MR imaging for endometrial cancer in assessing the depth of myometrial invasion. Especially, reduced FOV DW imaging has an advantage in assessing the depth of myometrial invasion for patients with coexisting adenomyosis. Reduced FOV DW imaging can be an alternative to 3D DCE MR imaging in evaluating myometrial invasion of endometrial cancer without the use of contrast medium. © 2018 by Japanese Society for Magnetic Resonance in Medicine This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. https://creativecommons.org/licenses/by-nc-nd/4.0/ Favorites & Alerts Recently viewed articles

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Condition tags

adenomyosis

MeSH descriptors

Diffusion Magnetic Resonance Imaging Endometrial Neoplasms Endometrial Neoplasms Imaging, Three-Dimensional Magnetic Resonance Imaging Myometrium Neoplasm Invasiveness Adult Aged Diffusion Magnetic Resonance Imaging Endometrial Neoplasms Endometrial Neoplasms Female Humans Imaging, Three-Dimensional Magnetic Resonance Imaging Middle Aged Myometrium Myometrium Neoplasm Invasiveness

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