THE ROLE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN GRADING OF CERVICAL AND ENDOMETRIAL CARCINOMA | ||||
| Ain Shams Medical Journal | ||||
| Article 15, Volume 73, Issue 3, September 2022, Page 625-641 PDF (716.44 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asmj.2022.270239 | ||||
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| Authors | ||||
| Mosab M. Taib Tifoor1; Sahar M. Al-fiky2; Amal I. Othman2 | ||||
| 1Najran Armed Forces Hospital, Najran - K.S.A | ||||
| 2Radiology Departement, Faculty of Medicine – Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Histological grade is one of the main prognostic factors in patients with endometrial and cervical carcinoma. DW-MRI provides important new information non-invasively. Aim of the Work: to investigate if there is a correlation between qualitative (visual) and quantitative (ADC value) provided by the diffusion weighted imaging and the pathological grade of endometrial and cervical carcinoma in order to reach the appropriate treatment options. Patients and Methods: Our study was conducted on twenty patients with pathologically proven endometrial (n=10) and cervical (n=10) carcinoma. It stressed on the role of Diffusion MRI in preoperative grading, aiming to emphasize its role in proper selection of patient’s management plan. We performed DWI using different b-values, and quantitative analysis, named apparent diffusion coefficient (ADC). Areas of restricted water diffusion of uterine malignancy demonstrated high signal intensity on DWI and lower ADC values on ADC map. Results: There was a significant difference (b < 0.01) between grades (1 and 2) from grade 3 in measuring the ADC values of both endometrial and cervical carcinoma, while there was no statistically significant difference between grade 1 and grade 2 or between grade 2 and grade 3. The mean ADC value of well differentiated tumors was (> 0.9 x 10-3 mm2/ sec), while that of poor differentiated tumors was (< 0.7 x 10-3 mm2/ sec). We also included in our analysis the size of the proved uterine cancer and aimed to establish another item that could reflect the tumor grading, but we haven’t reached a statistical significance in the current research; which could be due to the limited sample size. Conclusion: Lower ADC values were associated with poorly differentiated endometrial and cervical tumors. Therefore, the ADC value may represent a useful marker for assessing the biological features and grading of the uterine cancers. | ||||
| Keywords | ||||
| Diffusion; Magnetic Resonance Imaging; cervical and endometrial; carcinoma | ||||
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