Abstract:
Objective To assess the value of quantitative magnetic resonance imaging (MRI) parameters in the prediction of the pathological grade of endometrial carcinoma (EC).
Methods In this study, the MR images of 188 patients with a confirmed diagnosis of EC, on the basis of surgical pathology results, treated at Tianjin Medical University Cancer Institute and Hospital between February 2014 and January 2019 were analyzed retrospectively. The volumes of the neoplasm and uterus and the corresponding neoplasm/uterus volume ratio (N/U) were calculated. The apparent diffusion coefficient (ADC) of the lesion and three reference positions (normal uterine myometrium, musculus obturator internus, and gluteus maximus) was measured, and the mean ADC (ADCmean), the coefficient of variance of ADC, and the corresponding ADC ratio (rADC) were calculated. Differences in the pathological grades under various parameters were evaluated with a nonparametric test. The efficacy of various parameters in predicting high-grade EC was evaluated by receiver operating characteristic (ROC) and Logistic regression analyses.
Results N/U of high-grade EC was significantly higher than that of low-grade EC (P < 0.001). The mean ADC and three groups of rADC values for high-grade EC were significantly lower than those for lowgrade EC (all P < 0.001). Logistic regression analysis showed that N/U and rADC uterine myometrium independently predicted highgrade EC (P=0.018; P < 0.001). When N/U was more than 0.11 and rADC uterine myometrium was less than 0.65, the area under the curve of the combination of the two parameters was 0.777, with a sensitivity of 70.97% and a specificity of 70.97%.
Conclusions The quantitative MRI parameters N/U and rADC have potential value in predicting the pathological grade of EC before surgery.