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Diagnostic accuracy of MRI for evaluating myometrial invasion in endometrial cancer: a comparison of MUSE-DWI, rFOV-DWI, and DCE-MRI

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objectives

To compare the image quality of high-resolution diffusion-weighted imaging (DWI) using multiplexed sensitivity encoding (MUSE) versus reduced field-of-view (rFOV) techniques in endometrial cancer (EC) and to compare the diagnostic performance of these techniques with that of dynamic contrast-enhanced (DCE) MRI for assessing myometrial invasion of EC.

Methods

MUSE-DWI and rFOV-DWI were obtained preoperatively in 58 women with EC. Three radiologists assessed the image quality of MUSE-DWI and rFOV-DWI. For 55 women who underwent DCE-MRI, the same radiologists assessed the superficial and deep myometrial invasion using MUSE-DWI, rFOV-DWI, and DCE-MRI. Qualitative scores were compared using the Wilcoxon signed-rank test. Receiver operating characteristic analysis was performed to compare the diagnostic performance.

Results

Artifacts, sharpness, lesion conspicuity, and overall quality were significantly better with MUSE-DWI than with rFOV-DWI (p < 0.05). The area under the curve (AUC) of MUSE-DWI, rFOV-DWI, and DCE-MRI for the assessment of myometrial invasion were not significantly different except for significantly higher AUC of MUSE-DWI than that of DCE-MRI for superficial myometrial invasion (0.76 for MUSE-DWI and 0.64 for DCE-MRI, p = 0.049) and for deep myometrial invasion (0.92 for MUSE-DWI and 0.80 for DCE-MRI, p = 0.022) in one observer, and that of rFOV-DWI for deep myometrial invasion in another observer (0.96 for MUSE-DWI and 0.89 for rFOV-MRI, p = 0.048).

Conclusion

MUSE-DWI exhibits better image quality than rFOV-DWI. MUSE-DWI and rFOV-DWI shows almost equivalent diagnostic performance compared to DCE-MRI for assessing superficial and deep myometrial invasion in EC although MUSE-DWI may be helpful for some radiologists.

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Abbreviations

T2WI:

T2-weighted imaging

DCE:

Dynamic contrast-enhanced

EC:

Endometrial cancer

DWI:

Diffusion-weighted imaging

cDWI:

Conventional diffusion-weighted imaging

EPI:

Echo-planar imaging

rFOV:

Reduced field-of-view

FOV:

Field-of-view

MUSE:

Multiplexed sensitivity encoding

MUSE-DWI:

Multiplexed sensitivity encoding diffusion-weighted imaging

rFOV-DWI:

Reduced field-of-view diffusion-weighted imaging

NEX:

Number of excitations

SI:

Signal intensity

ADC:

Apparent diffusion coefficient

ROI:

Region of interest

SNR:

Signal-to-noise ratio

SD:

Standard deviation

CNR:

Contrast-to-noise ratio

ROC:

Receiver operating characteristic

ICC:

Intraclass correlation coefficients

AUC:

Area under the curve

PPV:

Positive predictive value

NPV:

Negative predictive value

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Takashi Ota, Takahiro Tsuboyama, Hiromitsu Onishi, Atsushi Nakamoto, Hideyuki Fukui, Keigo Yano, Toru Honda, Kengo Kiso, Mitsuaki Tatsumi & Noriyuki Tomiyama

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  1. Takashi Ota
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Correspondence to Takashi Ota.

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Takahiro Tsuboyama kindly provided statistical advice for this manuscript. One of the authors has significant statistical expertise.

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Ota, T., Tsuboyama, T., Onishi, H. et al. Diagnostic accuracy of MRI for evaluating myometrial invasion in endometrial cancer: a comparison of MUSE-DWI, rFOV-DWI, and DCE-MRI. Radiol med 128, 629–643 (2023). https://doi.org/10.1007/s11547-023-01635-4

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