Diffusion Weighted MRI Characterizes Uterine Masses
A number of studies described at the recent RSNA meeting detailed the benefits of diffusion-weighted (DWI) MRI exams for patients with uterine tumors, particularly endometrial and cervical malignancies. A report from the RSNA meeting was published by Diagnostic Imaging.
A research team at Massachusetts General Hospital retrospectively studied data from 65 women who collectively had 85 uterine lesions. All patients had DWI scanning with 1.5T MRI scanner equipped with a phased-array coil. Two blinded, independent radiologists reviewed studies to assess masses and describe both quantitative and qualitative parameters of such.Quantitative analysis included lesion measurement of ADC on sagittal and axial maps. An ADC lower than one was considered consistent with malignancy. Qualitative assessment compared lesions to the myometrium; lesions were graded malignant if hyperintense on DWI. They were also considered malignant if iso- or hypointense on the maps of apparent diffusion coefficients.
Both quantitative and qualitative analysis completed by the radiologists yielded data that was reproducible and suggestive of the appropriate diagnosis as either malignant or benign. The qualitative data had 79 percent sensitivity, 94 percent specificity, and 91 percent accuracy. As well, sagittal and axial maps were strongly correlated, which was highly statistically significant.
Importantly, use of the DWI in this context requires considerations of both the qualitative and quantitative assessments. The team at Mass General is collecting more data to further validate use of this approach. Two other research teams, one in Korea and one in Italy, also reported the benefits of DWI scanning in cohorts of patients with early-stage endometrial carcinoma and cervical cancer, respectively.
One benefit of such technique is DWI is a non-invasive means to aid diagnosis. The current approach to evaluate the extent of disease is surgical biopsy or catheter-access to the lesion. These invasive approaches are often utilized because both cervical and endometrial cancer are challenging to characterize.
November 30, 2007 Related topics: Imaging, Diagnostic, Radiology, Obstetrics, Gynecology & Neonatology