OBJECTIVES: To evaluate the usefulness of apparent diffusion coefficient (ADC) in discriminating metastatic from non-metastatic pelvic lymph nodal sites in endometrial cancer. MATERIALS AND METHODS: This retrospective study included 40 patients with endometrial cancer who underwent MRI [T2-weighted, dynamic T1-weighted images and diffusion-weighted images with body background suppression (DWIBS), b-values 0 and 1,000 s/mm(2)], total hysterectomy and pelvic lymphadenectomy. Lymph nodes identifiable on DWIBS were evaluated, classified into six nodal regions, and for each node ADC values, short- and long-axis diameters were measured by two readers. Histopathological findings and follow-up information served as the reference standard. RESULTS: Average (± standard deviation) mean and minimum ADC region value (0.87 ± 0.15 and 0.74 ± 0.07 × 10(-3) mm(2)/s) of metastatic sites (n = 7) were significantly lower than those of non-metastatic ones (n = 89; 1.07 ± 0.20 and 1.02 ± 0.20; p-value = 0.010 and 0.0004). Mean short-axis and short-to-long axis ratios of metastatic nodes were 7.47 mm and 0.68. Using the minimum ADC region value with threshold 0.807 × 10(-3) mm(2)/s, sensitivity, specificity, positive and negative predictive value and accuracy were 100 %, 98.3 %, 63.6 %, 100 % and 98.3 %, respectively (reader 1). CONCLUSION: In endometrial cancer, mean and minimum ADC region values of metastatic nodal sites are significantly lower than those found at normal sites. KEY POINTS : • Magnetic resonance imaging is widely used for endometrial cancer. • Nodes involved with metastases show lower ADC values than normal nodes. • ADC values show higher diagnostic performances than conventional size criteria. • Minimum region ADC values perform better than mean region ADC values. • The radiologist can indicate to the surgeon which nodal stations are involved.

Rechichi, G., Galimberti, S., Oriani, M., Perego, P., Valsecchi, M., Sironi, S. (2013). ADC maps in the prediction of pelvic lymph nodal metastatic regions in endometrial cancer. EUROPEAN RADIOLOGY, 23(1), 65-74 [10.1007/s00330-012-2575-2].

ADC maps in the prediction of pelvic lymph nodal metastatic regions in endometrial cancer

RECHICHI, GILDA;GALIMBERTI, STEFANIA;VALSECCHI, MARIA GRAZIA;SIRONI, SANDRO
2013

Abstract

OBJECTIVES: To evaluate the usefulness of apparent diffusion coefficient (ADC) in discriminating metastatic from non-metastatic pelvic lymph nodal sites in endometrial cancer. MATERIALS AND METHODS: This retrospective study included 40 patients with endometrial cancer who underwent MRI [T2-weighted, dynamic T1-weighted images and diffusion-weighted images with body background suppression (DWIBS), b-values 0 and 1,000 s/mm(2)], total hysterectomy and pelvic lymphadenectomy. Lymph nodes identifiable on DWIBS were evaluated, classified into six nodal regions, and for each node ADC values, short- and long-axis diameters were measured by two readers. Histopathological findings and follow-up information served as the reference standard. RESULTS: Average (± standard deviation) mean and minimum ADC region value (0.87 ± 0.15 and 0.74 ± 0.07 × 10(-3) mm(2)/s) of metastatic sites (n = 7) were significantly lower than those of non-metastatic ones (n = 89; 1.07 ± 0.20 and 1.02 ± 0.20; p-value = 0.010 and 0.0004). Mean short-axis and short-to-long axis ratios of metastatic nodes were 7.47 mm and 0.68. Using the minimum ADC region value with threshold 0.807 × 10(-3) mm(2)/s, sensitivity, specificity, positive and negative predictive value and accuracy were 100 %, 98.3 %, 63.6 %, 100 % and 98.3 %, respectively (reader 1). CONCLUSION: In endometrial cancer, mean and minimum ADC region values of metastatic nodal sites are significantly lower than those found at normal sites. KEY POINTS : • Magnetic resonance imaging is widely used for endometrial cancer. • Nodes involved with metastases show lower ADC values than normal nodes. • ADC values show higher diagnostic performances than conventional size criteria. • Minimum region ADC values perform better than mean region ADC values. • The radiologist can indicate to the surgeon which nodal stations are involved.
Articolo in rivista - Articolo scientifico
Diffusion, ADC, MRI, Endometrial cancer, Lymph nodes
English
gen-2013
23
1
65
74
none
Rechichi, G., Galimberti, S., Oriani, M., Perego, P., Valsecchi, M., Sironi, S. (2013). ADC maps in the prediction of pelvic lymph nodal metastatic regions in endometrial cancer. EUROPEAN RADIOLOGY, 23(1), 65-74 [10.1007/s00330-012-2575-2].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/38423
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