Related Experiment Video
Updated: Sep 3, 2026
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Quantitative Apparent Diffusion Coefficient (ADC) Mapping as a Preoperative Biomarker for Tumor Grade and Myometrial
Kamlesh Kumar Ratre1,2, Manish Kumar1, Priya Singh3
1Department of Radiodiagnosis, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Background:
The decision to perform systematic lymphadenectomy in endometrial carcinoma (EC) depends heavily on preoperative staging. We investigated the utility of diffusion-weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) mapping to noninvasively predict the presence of EC and its histological tumor grade.
Materials And Methods:
This prospective case-control study included 30 women with histopathologically confirmed EC (cases) and 30 women with normal endometrium (controls). Participants underwent 3.0T pelvic magnetic resonance imaging, including DWI (b-values: 0, 500, and 1000 s/mm2). Mean ADC values were calculated using manually delineated regions of interest and correlated with final surgical histopathology.
Results:
The mean ADC value was significantly lower in the EC group (0.89 ± 0.29 × 10-3 mm2/s) compared to the control group (1.70 ± 0.37 × 10-3 mm2/s) (P < 0.001). Receiver operating characteristic curve analysis identified an optimal upper-threshold ADC cutoff of 1.16 × 10-3 mm2/s, yielding 100% sensitivity, 86.7% specificity, and 94.6% accuracy for malignancy. Crucially, mean ADC values demonstrated a statistically significant inverse correlation with histological tumor grade, decreasing sequentially from Grade 1 (1.04 ± 0.15 × 10-3 mm2/s) to Grade 2 (0.84 ± 0.37 × 10-3 mm2/s) and Grade 3 (0.82 ± 0.29 × 10-3 mm2/s) (P = 0.015).
Conclusion:
Quantitative ADC mapping is a highly accurate, noninvasive biomarker for EC. The established cutoff reliably distinguishes malignancy, while the inverse correlation between ADC values and tumor grade provides critical preoperative intelligence to guide the extent of surgical staging.
