The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses

Al-Shimaa Magdy Ammar; Mohammed Mahmoud Dawoud; Mohamed Mohamed Hefeda; Manal Ezzat Badawy; Essmat Hamdy Abozaid

doi:doi:10.11648/j.ijmi.20190703.12

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The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses

Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid

Published in International Journal of Medical Imaging (Volume 7, Issue 3)

Received: 12 July 2019 Accepted: 15 August 2019 Published: 30 September 2019

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Abstract

The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value <0.001 and <0.001). The cut off value of ≤1.1×10^-3mm²/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.

Published in	International Journal of Medical Imaging (Volume 7, Issue 3)
DOI	10.11648/j.ijmi.20190703.12
Page(s)	66-80
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Uterine Masses, Endometrial Masses, DWI, Dynamic Contrast MRI, Functional MRI

References

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Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid. (2019). The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. International Journal of Medical Imaging, 7(3), 66-80. https://doi.org/10.11648/j.ijmi.20190703.12

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ACS Style

Al-Shimaa Magdy Ammar; Mohammed Mahmoud Dawoud; Mohamed Mohamed Hefeda; Manal Ezzat Badawy; Essmat Hamdy Abozaid. The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. Int. J. Med. Imaging 2019, 7(3), 66-80. doi: 10.11648/j.ijmi.20190703.12

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AMA Style

Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid. The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. Int J Med Imaging. 2019;7(3):66-80. doi: 10.11648/j.ijmi.20190703.12

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@article{10.11648/j.ijmi.20190703.12,
  author = {Al-Shimaa Magdy Ammar and Mohammed Mahmoud Dawoud and Mohamed Mohamed Hefeda and Manal Ezzat Badawy and Essmat Hamdy Abozaid},
  title = {The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses},
  journal = {International Journal of Medical Imaging},
  volume = {7},
  number = {3},
  pages = {66-80},
  doi = {10.11648/j.ijmi.20190703.12},
  url = {https://doi.org/10.11648/j.ijmi.20190703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20190703.12},
  abstract = {The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value -3mm2/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.},
 year = {2019}
}

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TY  - JOUR
T1  - The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses
AU  - Al-Shimaa Magdy Ammar
AU  - Mohammed Mahmoud Dawoud
AU  - Mohamed Mohamed Hefeda
AU  - Manal Ezzat Badawy
AU  - Essmat Hamdy Abozaid
Y1  - 2019/09/30
PY  - 2019
N1  - https://doi.org/10.11648/j.ijmi.20190703.12
DO  - 10.11648/j.ijmi.20190703.12
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 66
EP  - 80
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20190703.12
AB  - The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value -3mm2/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.
VL  - 7
IS  - 3
ER  -

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Author Information

Al-Shimaa Magdy Ammar

Radiology Department, Tanta University, Tanta, Egypt
Mohammed Mahmoud Dawoud

Radiology Department, Tanta University, Tanta, Egypt
Mohamed Mohamed Hefeda

Radiology Department, Tanta University, Tanta, Egypt
Manal Ezzat Badawy

Radiology Department, Tanta University, Tanta, Egypt
Essmat Hamdy Abozaid

Department of Obstetric and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt

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Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid. (2019). The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. International Journal of Medical Imaging, 7(3), 66-80. https://doi.org/10.11648/j.ijmi.20190703.12

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Al-Shimaa Magdy Ammar; Mohammed Mahmoud Dawoud; Mohamed Mohamed Hefeda; Manal Ezzat Badawy; Essmat Hamdy Abozaid. The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. Int. J. Med. Imaging 2019, 7(3), 66-80. doi: 10.11648/j.ijmi.20190703.12

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AMA Style

Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid. The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses. Int J Med Imaging. 2019;7(3):66-80. doi: 10.11648/j.ijmi.20190703.12

Copy | Download

@article{10.11648/j.ijmi.20190703.12,
  author = {Al-Shimaa Magdy Ammar and Mohammed Mahmoud Dawoud and Mohamed Mohamed Hefeda and Manal Ezzat Badawy and Essmat Hamdy Abozaid},
  title = {The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses},
  journal = {International Journal of Medical Imaging},
  volume = {7},
  number = {3},
  pages = {66-80},
  doi = {10.11648/j.ijmi.20190703.12},
  url = {https://doi.org/10.11648/j.ijmi.20190703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20190703.12},
  abstract = {The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value -3mm2/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.},
 year = {2019}
}

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TY  - JOUR
T1  - The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses
AU  - Al-Shimaa Magdy Ammar
AU  - Mohammed Mahmoud Dawoud
AU  - Mohamed Mohamed Hefeda
AU  - Manal Ezzat Badawy
AU  - Essmat Hamdy Abozaid
Y1  - 2019/09/30
PY  - 2019
N1  - https://doi.org/10.11648/j.ijmi.20190703.12
DO  - 10.11648/j.ijmi.20190703.12
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 66
EP  - 80
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20190703.12
AB  - The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value -3mm2/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.
VL  - 7
IS  - 3
ER  -

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