Endometrial carcinoma: diffusion-weighted imaging diagnostic accuracy and correlation with Ki-67 expression

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Endometrial carcinoma is a common gynecologic malignancy.
• Accurate staging and assessment of tumor biology are crucial for treatment planning and prognosis.
• Diffusion-weighted imaging (DWI) offers insights into tissue microstructure.

Purpose of the Study:

• To evaluate the diagnostic performance of DWI in detecting endometrial carcinoma.
• To correlate apparent diffusion coefficient (ADC) values with tumor grade, stage, and Ki-67 expression.

Main Methods:

• Prospective evaluation of 52 patients with invasive cancer using pelvic MRI with DWI.
• Measurement of ADC values from standard DWI sequences.
• Immunohistochemical analysis of Ki-67 expression in histological specimens.

Main Results:

• DWI detected endometrial carcinoma in 92.3% of patients.
• Significantly lower ADC values were observed in endometrial carcinoma compared to normal endometrium (p<0.001).
• ADC values correlated negatively with tumor grade (higher grade, lower ADC), stage (advanced stage, lower ADC), and Ki-67 expression (higher expression, lower ADC).

Conclusions:

• ADC values derived from DWI are valuable parameters for assessing tumor grade, stage, and proliferation in endometrial carcinoma.
• These findings may aid in improving patient prognosis and guiding treatment strategies.