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European Radiology
Published in: European Radiology 2/2019

01-02-2019 | Magnetic Resonance

Preoperative prediction of deep myometrial invasion and tumor grade for stage I endometrioid adenocarcinoma: a simple method of measurement on DWI

Authors: Bin Yan, Xiufen Liang, Tingting Zhao, Chen Niu, Caixia Ding, Wenjun Liu

Published in: European Radiology | Issue 2/2019

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Abstract

Objectives

To explore the utility of the tumor area ratio (TAR) for predicting deep myometrial invasion and tumor grade in stage I endometrioid adenocarcinoma (EEA).

Methods

We retrospectively evaluated 86 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I EEA. All patients underwent unenhanced contrast MRI and diffusion-weighted imaging (DWI) procedures. The volume and maximum area of the tumor and uterus were obtained, and the tumor volume ratio (TVR) and TAR were calculated. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the differences in indexes (TVR and TAR) between the different tumor grades and between superficial and deep myometrial invasion.

Results

The TVR and TAR values for deep myometrial invasion and high-grade EEA tumors were significantly higher than the values for superficial myometrial invasion and low-grade tumors (all p = 0.000). According to the receiver-operating characteristic (ROC) curve, the area under the curve (AUC) was significantly higher for TAR than for TVR for tumors with deep myometrial invasion (0.936 vs. 0.844, p = 0.045). However, no significant differences in the AUCs for TVR and TAR were observed between high- and low-grade tumors (0.865 vs. 0.863, p = 0.956). A TAR ≥ 34.6% predicted deep myometrial invasion in EEA with a sensitivity, specificity, and accuracy of 85.0%, 84.8%, and 86.0%, respectively. A TAR ≥ 38.9% predicted high-grade tumors with a sensitivity, specificity, and accuracy of 83.3%, 81.1%, and 82.6%, respectively.

Conclusion

TAR is useful for predicting deep myometrial invasion and high-grade stage I EEA

Key Points

• TAR is useful for predicting risk factors for EEA.
• TAR is easy to obtain and has high accuracy.
• TAR has excellent interobserver repeatability agreement (ICC range 95.1–99.6%).
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Metadata
Title
Preoperative prediction of deep myometrial invasion and tumor grade for stage I endometrioid adenocarcinoma: a simple method of measurement on DWI
Authors
Bin Yan
Xiufen Liang
Tingting Zhao
Chen Niu
Caixia Ding
Wenjun Liu
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5653-2

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