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Endometrial cancer: diagnostic value of quantitative measurements of microvascular changes with DCE-MR imaging

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Magnetic Resonance Materials in Physics, Biology and Medicine Aims and scope Submit manuscript

Abstract

Object

To assess the diagnostic value of dynamic contrast-enhanced (DCE) perfusion-magnetic resonance imaging (MRI) in detection, characterization and grading of endometrial cancer, using histopathological analysis as the standard of reference.

Materials and methods

Eighty patients with histologically proven endometrial carcinoma who underwent MRI (1.5 T magnet) of the pelvis for staging purposes were enrolled in the study. Each MR examination consisted of multiplanar T2 and T1-weighted turbo spin echo (TSE) sequences and T1-weighted gradient echo sequences before, during and after the administration of contrast medium. For each patient colour perfusion maps were derived from the dynamic sequences using a dedicated workstation. On the maps a region of interest was manually drawn both on normal myometrium and on the endometrial lesion. Then the following perfusion parameters were automatically calculated: relative enhancement (RE, %), maximum enhancement (ME, %), maximum relative enhancement (MRE, %) and time to peak (TTP, s).

Results

All patients underwent total hysterectomy. Histopathological analysis documented: G1 tumour in 21 patients, G2 tumour in 44 patients, G3 tumour in 14 patients and one squamous cell carcinoma. The following mean value perfusion parameters, with corresponding mean standard deviation, were obtained for endometrial cancer: RE (%) = 59.3 ± 36.3; ME (%) = 862.7 ± 475.9; MRE (%) = 75.3 ± 37.6 and TTP (s) = 164.7 ± 78. RE, ME and MRE were lower in tumour lesions than in normal myometrium (p < 0.001) and significantly higher values (p < 0.001) of perfusion parameters were obtained for G1 (well-differentiated) tumours as compared to those in G2 and G3 (moderately and poorly differentiated) lesions.

Conclusion

DCE perfusion-MRI can provide quantitative information on tissue vascularity, which may be of help in detecting endometrial cancer and in the assessment of tumour grading.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, University of Milano-Bicocca, Milan, Italy

    Davide Ippolito, Orazio Minutolo, Anna Cadonici, Cammillo Talei Franzesi, Pietro Bonaffini & Sandro Sironi

  2. Department of Pathology, H. S. Gerardo, Milan, Italy

    Patrizia Perego

Authors
  1. Davide Ippolito
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  2. Orazio Minutolo
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  3. Anna Cadonici
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  4. Cammillo Talei Franzesi
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  5. Pietro Bonaffini
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  6. Patrizia Perego
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  7. Sandro Sironi
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Correspondence to Davide Ippolito.

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Ippolito, D., Minutolo, O., Cadonici, A. et al. Endometrial cancer: diagnostic value of quantitative measurements of microvascular changes with DCE-MR imaging. Magn Reson Mater Phy 27, 531–538 (2014). https://doi.org/10.1007/s10334-014-0435-6

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  • DOI: https://doi.org/10.1007/s10334-014-0435-6

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