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

Authors
  • Yan, Bin1
  • Liang, Xiufen1
  • Zhao, Tingting2
  • Niu, Chen2
  • Ding, Caixia3
  • Liu, Wenjun4
  • 1 Xi’an Jiaotong University, Department of Radiology, Shaanxi Provincial Tumor Hospital, Xi’an Shaanxi, 710061, People’s Republic of China , Xi’an Shaanxi (China)
  • 2 The First Affiliated Hospital of Xi’an Jiaotong University, Department of Radiology, Xi’an Shaanxi, 710061, People’s Republic of China , Xi’an Shaanxi (China)
  • 3 Xi’an Jiaotong University, Department of Pathology, Shaanxi Provincial Tumor Hospital, Xi’an Shaanxi, 710061, People’s Republic of China , Xi’an Shaanxi (China)
  • 4 Xi’an Jiaotong University, Department of Epidemiology and Biotatistics, School of Public Health, Xi’an Shaanxi, 710061, People’s Republic of China , Xi’an Shaanxi (China)
Type
Published Article
Journal
European Radiology
Publisher
Springer-Verlag
Publication Date
Jul 23, 2018
Volume
29
Issue
2
Pages
838–848
Identifiers
DOI: 10.1007/s00330-018-5653-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectivesTo explore the utility of the tumor area ratio (TAR) for predicting deep myometrial invasion and tumor grade in stage I endometrioid adenocarcinoma (EEA).MethodsWe 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.ResultsThe 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.ConclusionTAR is useful for predicting deep myometrial invasion and high-grade stage I EEAKey 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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