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Time-dependent diffusion MRI differentiates atypical from conventional uterine leiomyomas: A preliminary study.
Jianli Yu1, Zhifei Du2, Yichen Wang3
1Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
European Journal of Radiology Open
|May 1, 2026
Summary
Time-dependent diffusion MRI (td-dMRI) offers superior differentiation between atypical and conventional uterine leiomyomas compared to routine MRI. This advanced technique provides quantitative microstructural insights for improved preoperative characterization and treatment planning.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Preoperative differentiation between atypical and conventional uterine leiomyomas is challenging due to overlapping MRI characteristics.
- Routine MRI sequences often show signal heterogeneity, complicating diagnosis.
Purpose of the Study:
- To assess if time-dependent diffusion MRI (td-dMRI) enhances the differentiation of atypical from conventional uterine leiomyomas.
- To compare the diagnostic performance of td-dMRI with routine MRI (T1WI, T2WI, DWI).
Main Methods:
- A prospective study included 119 patients with pathologically confirmed uterine leiomyomas.
- Both routine MRI and td-dMRI (using OGSE/PGSE sequences) were performed.
- Microstructural parameters and apparent diffusion coefficients (ADCs) were derived from td-dMRI, and compared with routine MRI findings.
Main Results:
- Atypical leiomyomas showed significantly lower intracellular fraction and cellularity, and higher extracellular diffusivity and ADCs compared to conventional leiomyomas.
- td-dMRI-based models achieved a higher area under the ROC curve (AUC) of 0.84 compared to routine MRI (AUC 0.76).
- Combining td-dMRI and routine MRI further improved diagnostic performance (AUC 0.86).
Conclusions:
- td-dMRI provides quantitative microstructural information for superior differentiation of uterine leiomyoma subtypes.
- td-dMRI shows promise as an adjunct tool for preoperative characterization and treatment planning of uterine leiomyomas.
