Preoperative staging of endometrial cancer using reduced field-of-view diffusion-weighted imaging: a preliminary study
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To compare the image quality and diagnostic performance of reduced field-of-view (rFOV) versus conventional full field-of-view (fFOV) diffusion-weighted (DW) imaging of endometrial cancer.
Fifty women with endometrial cancer underwent preoperative rFOV and fFOV DW imaging. Two radiologists compared the image qualities of both techniques, and five radiologists assessed superficial and deep myometrial invasion using both techniques. The statistical analysis included the Wilcoxon signed-rank test and paired t-test for comparisons of image quality and mean diagnostic values.
Distortion, tumour delineation, and overall image quality were significantly better with rFOV DW imaging, compared to fFOV DW imaging (P < 0.05); however, the former was inferior in noise (P < 0.05). Regarding superficial invasion, the mean accuracies of the techniques did not differ statistically (rFOV, 58.0% versus fFOV, 56.0%; P = 0.30). Regarding deep myometrial invasion, rFOV DW imaging yielded significantly better mean accuracy, specificity, and positive predictive values (88.4%, 97.8%, and 91.7%, respectively), compared with fFOV DW imaging (84.8%, 94.1%, and 77.4%, respectively; P = 0.009, 0.005, and 0.011, respectively).
Compared with fFOV DW imaging, rFOV DW imaging yielded less distortion, improved image quality and, consequently, better diagnostic performance for deep myometrial invasion of endometrial cancer.
• rFOV DWI yields better assessment of deep myometrial invasion in endometrial cancer.
• rFOV DWI could not sufficiently evaluate superficial invasion in endometrial cancer.
• Distortion, tumour delineation, and overall image quality were improved with rFOV DWI.
KeywordsMagnetic resonance imaging Diffusion-weighted Uterine neoplasms Endometrial neoplasms Neoplasm staging
- rFOV DW
reduced field-of-view diffusion-weighted
- fFOV DW
full field-of-view diffusion-weighted
- rFOV DW/T2-Weighted Imaging
reduced field-of-view diffusion-weighted imaging and T2-weighted imaging
- fFOV DW/T2-Weighted Imaging
full field-of-view diffusion-weighted imaging and T2-weighted imaging
apparent diffusion coefficient
The authors thank Enago (www.enago.jp) for the English language review. Yumiko Hori (Department of Pathology, Osaka University Graduate School of Medicine) kindly provided histopathological image for this study.
Compliance with ethical standards
The scientific guarantor of this publication is Masatoshi Hori.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
The authors state that this work has not received any funding.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution