Keywords:
Genital / Reproductive system female, Oncology, MR-Functional imaging, Imaging sequences, Neoplasia
Authors:
C. L. Piccolo, R. Del Vescovo, F. Giurazza, F. Pitocco, R. L. Cazzato, R. F. Grasso, B. Beomonte Zobel; Rome/IT
DOI:
10.1594/ecr2013/C-0733
Conclusion
MR imaging is very accurate in the assessment of endometrial cancer,
delineating its local extent and its involvement of myometrial thickness; in particular,
on DWI,
EC shows impeded diffusion compared with surrounding tissue,
showing high signal intensity and low signal intensity on ADC map,
providing a quantitative measure of water diffusion.
DWI should always be reviewed with its ADC maps to avoid pitfalls such as T2 shine-through effect.
(5-7)
The added value of DWI in assessing EC local extend is not yet well established such as for dynamic contrast-enhanced (DCE) one; infact, its diagnostic accuracy ranges from 62-90% (8).
Rechichi et al (9) demonstrated that the staging accuracy of DWI is better than DCE,
suggesting that DWI could replace the DCE in the staging of EC,
reducing scanning time and also the administration of i.v.
contrast agent.
Moreover,
there are a lot of conflicting results about the role of MRI in detecting metastatic nodes; infact reactive nodes have high signal intensity on DWI,
which it has been reported both for benign than malignant ones (10).Nakai et al (11) reported that ADC maps were unable to differentiate benign from malignant nodes; however they found that DWI was useful in the detection of lymph-nodes.