Endometrial carcinoma: Evaluation using diffusion‐tensor imaging and its correlation with histopathologic findings

Background Although the prognosis of endometrial carcinoma (EMC) patients strictly depends on tumor invasion depth and its histologic grade, accurate preoperative assessment of these prognostic factors is often difficult. Purpose To determine the usefulness of diffusion‐tensor imaging (DTI) as a noninvasive method for evaluating tumor invasion depth and its histologic grade in patients with EMC. Study Type Prospective. Population Twenty‐five consecutive patients with histologically confirmed EMC who were surgically treated at our institution. Field Strength/Sequence DTI was performed with a 1.5T MRI system using a single‐shot echo‐planar imaging sequence with b values of 0 and 1000 s/mm2 and motion‐probing gradients in nine noncollinear directions. Assessment Fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD) maps were analyzed by three observers and compared with histopathologic findings. Statistical Tests Dunnett's test, Spearman's rank correlation coefficient, and receiver operating characteristic (ROC) curve analyses. Results FA maps from all patients distinctly identified the junctional zone as a high‐FA zone (0.864 ± 0.037) that was significantly different from the endometrium and outer myometrium (0.251 ± 0.030 and 0.471 ± 0.091, respectively; P