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Diffusion-weighted MRI in the differential diagnosis of uterine endometrial cavity tumors

Background: This study aimed to investigate the efficacy of quantitative apparent diffusion coefficient (ADC) measurement in the differential diagnosis of the uterine endometrial cavity tumors (UECT).

Methods: This study included consecutive 36 female patients with UECT. The groups were formed as follows: group 1, patients with endometrial carcinoma; group 2, patients with endometrial polyp; group 3, patients with submucosal leiomyoma; and additionally group A, patients with malignant lesion; group B patients with benign lesion. Tumoral and outer myometrial ADC values were measured and the tumor–myometrium ADC ratios were calculated in all patients. Kolmogorov–Smirnov tests were used to test the normality of the data distributions. The data were not normally distributed, and therefore, nonparametric tests were performed. The cut-off values, sensitivity, and specificity were determined by the receiver operating characteristic analysis.

Results: The mean ADC value and ratio of group 1 were lower than that of group 2 and 3, and the mean ADC value and ratio of group 3 were lower than that of group 2. The sensitivity and specificity for group 1, 2, and 3 were as follows: 90, 100, and 66.7 %; and 81.8, 88, and 58.8 %, respectively, in terms of the ADC values; 90, 100 and 67 %; and 77.3, 96, and 64.7 % in terms of the ADC ratios. Statistically significant differences were demonstrated between group A and B in terms of mean tumoral ADC values and ratios. Sensitivity and specificity were found to be 90 and 81.8 %, respectively, in terms of the ADC values. The sensitivity and specificity were found to be 90 and 77.3 %, respectively, in terms of the ADC ratios.

Conclusions: ADC values and ratios represent a promising parameter in the determination of the tumoral lesions in patients with UECT.

Asst. Prof. Omer Karakas, Asst. Prof. Dr. Ekrem Karakas, Ferit Dogan, Nihat Kilicaslan, Asst. Prof. Aysun Camuzcuoglu, Asst. Prof. Adnan Incebiyik, Asst. Prof. Hakan Camuzcuoglu, Wiener klinische Wochenschrift 7/8/2015

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