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Dynamic Contrast-Enhanced MR Imaging of Endometrial Cancer: Optimizing the Imaging Delay for Tumour-Myometrium Contrast

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Abstract

Purpose

To investigate the optimal imaging delay time of dynamic contrast-enhanced magnetic resonance (MR) imaging in women with endometrial cancer.

Materials and Methods

This prospective single-institution study was approved by the institutional review board, and informed consent was obtained from the participants. Thirty-five women (mean age, 54 years; age range, 29–66 years) underwent dynamic contrast-enhanced MR imaging with a temporal resolution of 25–40 seconds. The signal intensity difference ratios between the myometrium and endometrial cancer were analyzed to investigate the optimal imaging delay time using single change-point analysis.

Results

The optimal imaging delay time for appropriate tumour-myometrium contrast ranged from 31.7 to 268.1 seconds. The median optimal imaging delay time was 91.3 seconds, with an interquartile range of 46.2 to 119.5 seconds. The median signal intensity difference ratios between the myometrium and endometrial cancer were 0.03, with an interquartile range of -0.01 to 0.06, on the pre-contrast MR imaging and 0.20, with an interquartile range of 0.15 to 0.25, on the post-contrast MR imaging.

Conclusion

An imaging delay of approximately 90 seconds after initiating contrast material injection may be optimal for obtaining appropriate tumour-myometrium contrast in women with endometrial cancer.

Key Points

Recent advances have allowed for MR imaging of high temporal resolution.

Contrast-enhanced MR imaging is helpful for evaluation of endometrial cancer.

An imaging delay of 90 seconds may be optimal.

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References

  1. Freeman SJ, Aly AM, Kataoka MY, Addley HC, Reinhold C, Sala E (2012) The revised FIGO staging system for uterine malignancies: implications for MR imaging. Radiographics 32:1805–1827

    Article  PubMed  Google Scholar 

  2. Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA: Cancer J Clin 62:10–29

    Article  Google Scholar 

  3. Boronow R, Morrow C, Creasman W et al (1984) Surgical staging in endometrial cancer: clinical-pathologic findings of a prospective study. Obstet Gynecol 63:825–832

    PubMed  CAS  Google Scholar 

  4. PIVER MS, LELE SB, BARLOW JJ, BLUMENSON L (1982) Paraaortic lymph node evaluation in stage I endometrial carcinoma. Obstet Gynecol 59:97–100

    PubMed  CAS  Google Scholar 

  5. Sala E, Wakely S, Senior E, Lomas D (2007) MRI of malignant neoplasms of the uterine corpus and cervix. Am J Roentgenol 188:1577–1587

    Article  Google Scholar 

  6. Hori M, Kim T, Onishi H et al (2013) Endometrial cancer: preoperative staging using three-dimensional T2-weighted turbo spin-echo and diffusion-weighted MR imaging at 3.0 T: a prospective comparative study. Eur Radiol 23:2296–2305

    Article  PubMed  Google Scholar 

  7. Sala E, Rockall AG, Freeman SJ, Mitchell DG, Reinhold C (2013) The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology 266:717–740

    Article  PubMed  Google Scholar 

  8. Wakefield JC, Downey K, Kyriazi S, deSouza NM (2013) New MR Techniques in Gynecologic Cancer. Am J Roentgenol 200:249–260

    Article  Google Scholar 

  9. Sironi S, Colombo E, Villa G et al (1992) Myometrial invasion by endometrial carcinoma: assessment with plain and gadolinium-enhanced MR imaging. Radiology 185:207–212

    Article  PubMed  CAS  Google Scholar 

  10. Seki H, Kimura M, Sakai K (1997) Myometrial invasion of endometrial carcinoma: assessment with dynamic MR and contrast-enhanced T1-weighted images. Clin Radiol 52:18–23

    Article  PubMed  CAS  Google Scholar 

  11. Sala E, Crawford R, Senior E et al (2009) Added value of dynamic contrast-enhanced magnetic resonance imaging in predicting advanced stage disease in patients with endometrial carcinoma. Int J Gynecol Cancer 19:141–146

    Article  PubMed  Google Scholar 

  12. Sala E, Rockall A, Rangarajan D, Kubik-Huch RA (2010) The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. Eur J Radiol 76:367–385

    Article  PubMed  Google Scholar 

  13. Hinkley DV (1970) Inference about the change-point in a sequence of random variables. Biometrika 57:1–17

    Article  Google Scholar 

  14. Killick R, Eckley IA (2011) Changepoint: an R package for changepoint analysis. Lancaster University

  15. Killick R, Fearnhead P, Eckley I (2012) Optimal detection of changepoints with a linear computational cost. J Am Stat Assoc 107:1590–1598

    Article  CAS  Google Scholar 

  16. Moratal D, Vallés-Luch A, Martí-Bonmatí L, Brummer ME (2008) k-Space tutorial: an MRI educational tool for a better understanding of k-space. Biomed Imaging Interv J 4:e15

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Kanematsu M, Semelka RC, Matsuo M et al (2002) Gadolinium-enhanced MR Imaging of the Liver: Optimizing Imaging Delay for Hepatic Arterial and Portal Venous Phases—A Prospective Randomized Study in Patients with Chronic Liver Damage1. Radiology 225:407–415

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the research fund of the Radiological Research Foundation of Korea (2011-03), and we thank Chun Ho Kang, who participated in the acquisition of MR images. The scientific guarantor of this publication is Dr. Min Hoan Moon. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective observational study, performed at one institution.

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Correspondence to Min Hoan Moon.

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Park, S.B., Moon, M.H., Sung, C.K. et al. Dynamic Contrast-Enhanced MR Imaging of Endometrial Cancer: Optimizing the Imaging Delay for Tumour-Myometrium Contrast. Eur Radiol 24, 2795–2799 (2014). https://doi.org/10.1007/s00330-014-3327-2

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  • DOI: https://doi.org/10.1007/s00330-014-3327-2

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