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Feasibility of intravoxel incoherent motion diffusion-weighted imaging in distinguishing adenocarcinoma originated from uterine corpus or cervix

Abdominal Radiology volume 46, pages 732–744 (2021)Cite this article

Abstract

Purpose

To prospectively assess the incremental value of intravoxel incoherent motion (IVIM) DWI in determining whether the adenocarcinoma originated from the uterine corpus or cervix.

Methods

Eighty consecutive uterine adenocarcinomas from the cervix or endometrium confirmed by histopathology underwent IVIM DWI acquisition on a 3.0T MR scanner before treatment. Five morphologic features were analyzed using Fisher exact test; IVIM DWI-derived parameters, including apparent diffusion coefficient (ADC), true coefficient diffusivity (D), perfusion-related diffusivity (D*), and perfusion fraction (f) were compared using two-sample independent t-test or Mann–Whitney U test. Logistic regression analysis was used to develop different diagnosis model. The ROCs of these variables and diagnostic models were compared to evaluate the diagnostic efficiency.

Results

Among single morphologic features, tumor location yielded the highest AUC of 0.891 in distinguishing endometrial adenocarcinoma (EAC) from cervical adenocarcinoma (CAC). Among single IVIM DWI-derived parameters, f values showed the best diagnostic performance (AUC: 0.837) at the optimal cut-off value of 0.261. Additionally, the combined diagnostic model, which consisted of tumor location, ADC and f showed the largest AUC of 0.967 with the highest sensitivity of 88.14%, highest specificity of 100.00%, and highest accuracy of 91.25%.

Conclusion

IVIM DWI-derived parameters add additional diagnostic value to conventional morphologic features. A combined diagnosis model is a promising imaging tool for predicting the origin of uterine adenocarcinoma, further contributing to therapeutic decision-making.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Xinming Zhao and Xiaoduo Yu have contributed equally to this work.

Affiliations

  1. Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Qi Zhang, Han Ouyang, Feng Ye, Ying Song, Xinming Zhao & Xiaoduo Yu

  2. GE Healthcare, MR Research China, Beijing, China

    Lizhi Xie

Authors
  1. Qi Zhang
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  2. Han Ouyang
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  3. Feng Ye
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  4. Ying Song
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  5. Lizhi Xie
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  7. Xiaoduo Yu
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Correspondence to Xinming Zhao or Xiaoduo Yu.

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Zhang, Q., Ouyang, H., Ye, F. et al. Feasibility of intravoxel incoherent motion diffusion-weighted imaging in distinguishing adenocarcinoma originated from uterine corpus or cervix. Abdom Radiol 46, 732–744 (2021). https://doi.org/10.1007/s00261-020-02586-4

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  • DOI: https://doi.org/10.1007/s00261-020-02586-4

Keywords

  • Uterine neoplasms
  • Magnetic resonance imaging
  • Diffusion
  • Perfusion
  • Differential diagnosis