Share this content in WeChat
Experience Exchanges
Utility of delta ADC value to differentiate uterine carcinosarcoma from endometrial carcinomas
LIU Yuhang  LIU Yang  XIAO Zhibo  DAI Mengying  XIONG Yulin 

Cite this article as: Liu YH, Liu Y, Xiao ZB, et al. Utility of delta ADC value to differentiate uterine carcinosarcoma from endometrial carcinomas[J]. Chin J Magn Reson Imaging, 2022, 13(3): 79-82. DOI:10.12015/issn.1674-8034.2022.03.016.

[Abstract] Objective To investigate the utility of delta apparent diffusion coefficient values (dADC) to diagnose uterine carcinosarcoma (UCS), and to evaluate the efficacy of combined dADC and time-intensity curve (TIC) in differentiating UCS from endometrial carcinomas (EC).Materials and Methods DWI and DCE-MRI findings of 28 pathologically proven UCSs obtained on preoperative MRI were retrospectively evaluated. The DWI parameters including mean apparent diffusion coefficient value (mADC), delta apparent diffusion coefficient value (dADC= maximum ADC-minimum ADC) and DCE-MRI parameter including time-intense curve (TIC) type were compared with those of 49 pathologically proven ECs. The efficiency of above parameters in differentiating UCSs from ECs was evaluated by receiver operating characteristic (ROC) curve.Results dADC values in UCS group were higher than that in EC group with significant difference (P<0.01). UCSs were more frequently associated with type Ⅰ TIC, while ECs were associated with type Ⅱ. ROC analysis revealed that with the combination of dADC and TIC, the diagnostic sensitivity, specificity and area under the curve were 96.4%, 95.9% and 0.966 respectively with significant difference when compared with individual parameter (P<0.05).Conclusions dADC was helpful in the diagnosis of UCS. Higher dADC values were associated with more possibility of diagnosing UCS. dADC combined with TIC was of great value in differentiating UCS from EC preoperatively and could be used to provide additional information in treatment planning.
[Keywords] uterine carcinosarcoma;endometrial neoplasms;magnetic resonance imaging;apparent diffusion coefficient;time-intensity curve;differential diagnosis

LIU Yuhang1   LIU Yang2   XIAO Zhibo1*   DAI Mengying2   XIONG Yulin3  

1 Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

2 State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing 400016, China

3 Department of Radiology, Chongqing Hospital, University of Chinese Academy of Sciences (Chongqing People's Hospital), Chongqing 400013, China

Xiao ZB, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS 2020 Chongqing Postgraduate Scientific Research Innovation Project (No. CYB20165).
Received  2021-08-30
Accepted  2022-03-07
DOI: 10.12015/issn.1674-8034.2022.03.016
Cite this article as: Liu YH, Liu Y, Xiao ZB, et al. Utility of delta ADC value to differentiate uterine carcinosarcoma from endometrial carcinomas[J]. Chin J Magn Reson Imaging, 2022, 13(3): 79-82. DOI:10.12015/issn.1674-8034.2022.03.016.

Takahashi M, Kozawa E, Tanisaka M, et al. Utility of histogram analysis of apparent diffusion coefficient maps obtained using 3.0 T MRI for distinguishing uterine carcinosarcoma from endometrial carcinoma[J]. J Magn Reson Imaging, 2016, 43(6): 1301-1307. DOI: 10.1002/jmri.25103.
Pezzicoli G, Moscaritolo F, Silvestris E, et al. Uterine carcinosarcoma: an overview[J]. Crit Rev Oncol Hematol, 2021, 163: 103369. DOI: 10.1016/j.critrevonc.2021.103369.
Matsuzaki S, Klar M, Matsuzaki S, et al. Uterine carcinosarcoma: contemporary clinical summary, molecular updates, and future research opportunity[J]. Gynecol Oncol, 2021, 160(2): 586-601. DOI: 10.1016/j.ygyno.2020.10.043.
Santoro A, Angelico G, Travaglino A, et al. New pathological and clinical insights in endometrial cancer in view of the updated ESGO/ESTRO/ESP guidelines[J]. Cancers (Basel), 2021, 13(11): 2623. DOI: 10.3390/cancers13112623.
Yamagami W, Mikami M, Nagase S, et al. Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms[J]. J Gynecol Oncol, 2020, 31(1): e18. DOI: 10.3802/jgo.2020.31.e18.
Takeuchi M, Matsuzaki K, Harada M. Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy[J]. Acta Radiol, 2016, 57(10): 1277-1284. DOI: 10.1177/0284185115626475.
Otero-García MM, Mesa-Álvarez A, Nikolic O, et al. Role of MRI in staging and follow-up of endometrial and cervical cancer: pitfalls and mimickers[J]. Insights Imaging, 2019, 10(1): 19. DOI: 10.1186/s13244-019-0696-8.
Sagebiel TL, Bhosale PR, Patnana M, et al. Uterine carcinosarcomas[J]. Semin Ultrasound CT MRI, 2019, 40(4): 295-301. DOI: 10.1053/j.sult.2019.03.004.
Huang YT, Huang YL, Ng KK, et al. Current status of magnetic resonance imaging in patients with malignant uterine neoplasms: a review[J]. Korean J Radiol, 2019, 20(1): 18-33. DOI: 10.3348/kjr.2018.0090.
Bruno F, Arrigoni F, Mariani S, et al. Advanced magnetic resonance imaging (MRI) of soft tissue tumors: techniques and applications[J]. Radiol Med, 2019, 124(4): 243-252. DOI: 10.1007/s11547-019-01035-7.
Sala E, Rockall A, Rangarajan D, et al. The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis[J]. Eur J Radiol, 2010, 76(3): 367-385. DOI: 10.1016/j.ejrad.2010.01.026.
Chen Y, Cheng JL, Bai J, et al. DWI and dynamic contrast-enhanced MRI in differential diagnosis of stage-Ⅰ a endometrial carcinomas and endometrial polyps[J]. Chin J Med Imaging Technol, 2017, 33(1): 70-74. DOI: 10.13929/j.1003-3289.201607038.
Kim JY, Kim JJ, Hwangbo L, et al. Diffusion-weighted MRI of estrogen receptor-positive, HER2-negative, node-negative breast cancer: association between intratumoral heterogeneity and recurrence risk[J]. Eur Radiol, 2020, 30(1): 66-76. DOI: 10.1007/s00330-019-06383-6.
Choi BB. Effectiveness of ADC difference value on pre-neoadjuvant chemotherapy MRI for response evaluation of breast cancer[J]. Technol Cancer Res Treat, 2021, 20: 15330338211039129. DOI: 10.1177/15330338211039129.
El Hallani S, Arora R, Lin DI, et al. Mixed endometrioid adenocarcinoma and müllerian adenosarcoma of the uterus and ovary[J]. Am J Surg Pathol, 2020, 45(3): 374-383. DOI: 10.1097/pas.0000000000001643.
Liu Y, Ye ZX, Sun HR, et al. Clinical application of diffusion-weighted magnetic resonance imaging in uterine cervical cancer[J]. Int J Gynecol Cancer, 2015, 25(6): 1073-1078. DOI: 10.1097/IGC.0000000000000472.
Sertic M, Kilcoyne A, Catalano OA, et al. Quantitative imaging of uterine cancers with diffusion-weighted MRI and 18-fluorodeoxyglucose PET/CT[J]. Abdom Radiol (NY), 2021: 1-15. DOI: 10.1007/s00261-021-03218-1.
Dreher C, Kuder TA, König F, et al. Modulating diffusion-weighted magnetic resonance imaging for screening in oncologic tertiary prevention: a prospective ex vivo and in vivo study[J]. Invest Radiol, 2019, 54(11): 704-711. DOI: 10.1097/RLI.0000000000000596.
Carcangiu M, Kurman RJ, Carcangiu ML, et al. WHO classification of tumours of female reproductive organs[M]. International Agency for Research on Cancer, 2014.
Garza A, Elsherif SB, Faria SC, et al. Staging MRI of uterine malignant mixed Müllerian tumors versus endometrial carcinomas with emphasis on dynamic enhancement characteristics[J]. Abdom Radiol (NY), 2020, 45(4): 1141-1154. DOI: 10.1007/s00261-019-02096-y.
Shen YQ, Lü FJ, Liu XX, et al. The applied value of multiparametric MRI in differentiating uterine carcinosarcoma from low risk endometrial carcinoma[J]. Chin J Magn Reson Imaging, 2019, 10(7): 535-539. DOI: 10.12015/issn.1674-8034.2019.07.011.
Ippolito D, Minutolo O, Cadonici A, et al. Endometrial cancer: diagnostic value of quantitative measurements of microvascular changes with DCE-MR imaging[J]. MAGMA, 2014, 27(6): 531-538. DOI: 10.1007/s10334-014-0435-6.
Lin M, Zhang Q, Song Y, et al. Differentiation of endometrial adenocarcinoma from adenocarcinoma of cervix using kinetic parameters derived from DCE-MRI[J]. Eur J Radiol, 2020, 130: 109190. DOI: 10.1016/j.ejrad.2020.109190.
Fasmer KE, Bjørnerud A, Ytre-Hauge S, et al. Preoperative quantitative dynamic contrast-enhanced MRI and diffusion-weighted imaging predict aggressive disease in endometrial cancer[J]. Acta Radiol, 2018, 59(8): 1010-1017. DOI: 10.1177/0284185117740932.

PREV Application of Care-bolus technique at different monitoring levels in displaying sub endometrial enhancement
NEXT The diagnostic value of short T1 signal and ADC value in benign and malignant ovarian lesions

Tel & Fax: +8610-67113815    E-mail: