Purpose: In this study, we aimed to determine the usefulness of diffusion kurtosis imaging (DKI) as a noninvasive method for the evaluation of tumor invasion depth, histological grade, and lymph node metastasis in patients with endometrial carcinoma (EMC).
Materials and methods: Our institutional review board approved this retrospective study and waived informed consent. In total, 24 patients suspected of having EMC were examined by a 1.5-T magnetic resonance imaging. DKI data were obtained using a single-shot echo-planar imaging sequence with four b values (0, 500, 1000, and 2000 s/mm2). Kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) maps were generated and compared with histopathological findings.
Results: K maps from all patients identified the junctional zone as a distinct high-K zone (1.443 ± 0.362). This zone was significantly different from the zone of endometrium and outer myometrium (0.678 ± 0.179 and 0.694 ± 0.113, respectively; P < 0.001). K and D values of all EMCs were significantly different from those of all normal uterine wall layers. K and D values were significantly correlated with histological grades of endometrioid adenocarcinomas (r = 0.799, P < 0.001 and r = -0.799, P < 0.001, respectively), while ADC values were not (r = -0.243, P = 0.382). Metastatic and nonmetastatic lymph nodes showed significantly different K (P = 0.001) and D (P = 0.001) values, but not ADC values (P = 0.827).
Conclusions: DKI may be clinically useful for the noninvasive evaluation of depth of tumor invasion, histological grade, and lymph node metastasis in patients with EMC.
Keywords: Diffusion kurtosis imaging; Diffusion-weighted imaging; Endometrial carcinoma; Lymph node; MR imaging; Uterus.
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