Endometrial cancer: Utility of diffusion-weighted magnetic resonance imaging with background body signal suppression at 3T

Purpose: To prospectively assess the usefulness of diffusion-weighted magnetic resonance imaging (MRI) with background body signal suppression (DWIBS) at 3T for the preoperative evaluation of endometrial cancer. Materials and Methods: Fifty-two consecutive patients with biopsy-proven endometrial cancer were examined with a 3T MR scanner, followed by a hysterectomy. MR examinations included T2-weighted (T2WI), DWIBS, and dynamic contrast-enhanced T1-weighted imaging (DCEI). The apparent diffusion coefficient (ADC) was calculated in the tumor and normal myometrium. According to tumor grade, the mean ADC of the tumor was analyzed. The depth of myometrial invasion was independently assessed by two radiologists for three MRI datasets on a five-point scale. Results: The mean ADC of the tumors was significantly lower than that of normal myometrium (P < 0.001). The mean ADC of grades 2 or 3 was significantly lower than grade 1 (P < 0.01). For predicting myometrial invasion, the specificity, accuracy, and area under the curve of combined T2WI and DWIBS in both readers were similar to DCEI (P > 0.05). Interreader agreement in all MRI datasets was excellent. Conclusion: DWIBS at 3T has potential for being an effective method for the preoperative evaluation of endometrial cancer. J. Magn. Reson. Imaging 2013;37:11511159. (c) 2012 Wiley Periodicals, Inc.