Preoperative quantitative dynamic contrast-enhanced MRI and diffusion-weighted imaging predict aggressive disease in endometrial cancer

Abstract

Background

Quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) may yield preoperative tumor biomarkers relevant for prognosis and therapy in cancer.

Purpose

To explore the value of preoperative DCE-MRI and DWI for the prediction of aggressive disease in endometrial cancer patients.

Material and Methods

Preoperative MRI (1.5-T) from 177 patients were analyzed and imaging parameters reflecting tumor microvasculature (from DCE-MRI) and tumor microstructure (from DWI) were estimated. The derived imaging parameters were explored in relation to clinico-pathological stage, histological subtype and grade, molecular markers, and patient outcome.

Results

Low tumor blood flow (F_b) and low rate constant for contrast agent intravasation (k_ep) were associated with high-risk histological subtype (P ≤ 0.04 for both) and tended to be associated with poor prognosis (P ≤ 0.09). Low tumor apparent diffusion coefficient (ADC) value and large tumor volume were both significantly associated with deep myometrial invasion (P < 0.001 for both) and were also unfavorable prognostic factors (P = 0.05 and P < 0.001, respectively).

Conclusion

DCE-MRI and DWI represent valuable supplements to conventional MRI by providing preoperative imaging biomarkers that predict aggressive disease in endometrial cancer patients.

Keywords

Magnetic resonance imaging (MRI)functional MRI MR diffusion/perfusion prognostic biomarker endometrial carcinoma

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