E-ISSN 1305-3612
Abdominal Imaging - Original Article
Quantitative assessment of diffusion kurtosis imaging depicting deep myometrial invasion: a comparative analysis with diffusion-weighted imaging
1 Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China  
2 Department of Gynaecology and Obstetrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China  
Diagn Interv Radiol ; : -



PURPOSE: To investigate histogram analysis of diffusion kurtosis imaging (DKI) and conventional diffusion-weighted imaging (DWI) to distinguish between deep myometrial invasion and superficial myometrial invasion in endometrial carcinoma (EC).


METHODS: A total of 118 pathologically confirmed EC patients with preoperative DWI were included. The data were postprocessed with a DKI (b value of 0, 700, 1400, and 2000 s/mm2) model for quantitation of apparent diffusion values (D) and apparent kurtosis coefficient values (K) for non-Gaussian distribution. The apparent diffusion coefficient (ADC) was postprocessed with a conventional DWI model (b values of 0 and 800 sec/mm2). A whole-tumor analysis approach was used. Comparisons of the histogram parameters of D, K and ADC were carried out for the deep myometrial invasion and superficial myometrial invasion subgroups. Diagnostic performance of the imaging parameters was assessed.


RESULTS: The Dmean, D10th, and D90th in deep myometrial invasion group were significantly lower than those in superficial invasion group (P < 0.001, <0.001 and =0.023, respectively), as well as the ADCmean, ADC10th, and ADC90th (P = 0.001, 0.001 and 0.042, respectively). The Kmean and K90th were significantly higher in deep invasion group than those in superficial myometrial invasion group (P = 0.002, and 0.026, respectively). The D10th, Kmean, and ADC10th had a relatively higher area under the curve (AUC) (0.72, 0.66, and 0.71, respectively) than other parameters did for distinguishing deep myometrial invasion of EC. D10th showed a relatively higher AUC than ADC10th did for the differentiation of lesions with deep myometrial invasion from those with superficial myometrial invasion (0.72 vs 0.71), but the variation was not statistically significant (P = 0.35).


CONCLUSION: Distribution of DKI and conventional DWI parameters characterized by histogram analysis may represent an indicator for deep myometrial invasion in EC. Both DKI and DWI models showed relatively equivalent efficacy.

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