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Accuracy of semiquantitative dynamic contrast‐enhanced MRI for differentiating type II from type I endometrial carcinoma
Author(s) -
Fukunaga Takeru,
Fujii Shinya,
Inoue Chie,
Kato Ayumi,
Chikumi Jun,
Kaminou Toshio,
Ogawa Toshihide
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24730
Subject(s) - carcinoma , medicine , cutoff , magnetic resonance imaging , receiver operating characteristic , nuclear medicine , dynamic contrast , mann–whitney u test , dynamic contrast enhanced mri , radiology , pathology , physics , quantum mechanics
Purpose To investigate type II endometrial carcinoma characterization using dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and evaluate the diagnostic accuracy of semiquantitative DCE‐MRI in differentiating type II from type I tumors. Materials and Methods Seventy‐seven patients with endometrial carcinoma were retrospectively evaluated using 3T DCE‐MRI. The maximum absolute enhancement of signal intensity (SImax), maximum relative enhancement (SIrel), wash‐in rate (WIR), and the SImax/SI (piriformis) ratio were analyzed. To differentiate type I from type II tumors, optimal threshold criteria were established. The Mann–Whitney U ‐test was used for statistical comparison and receiver operating characteristic curve analysis was used to determine optimal cutoff values. Results The SIrel ( P < 0.001), WIR ( P < 0.0001), and SImax/SI (piriformis) ratio ( P < 0.0001), but not SImax, differed significantly between type I and type II carcinomas. Cutoff values of SIrel ≥58.8, WIR ≥37.0, and SImax/SI (piriformis) ratio ≥1.55 had sensitivities of 93%, 93%, and 67%, specificities of 60%, 60%, and 79%, accuracies of 66%, 66%, and 67%, respectively, for predicting type II endometrial carcinoma. Conclusion Endometrial carcinoma with strong (high level) enhancement on DCE‐MRI is suggestive of type II endometrial carcinoma. Semiquantitative evaluation of DCE‐MRI may be useful for differentiating type II from type I tumors. J. Magn. Reson. Imaging 2015;41:1662–1668 . © 2014 Wiley Periodicals, Inc .