Unveiling the Impact of Dynamic Contrast-Enhanced and Diffusion-Weighted MRI in Endometrial and Cervical Carcinoma Management

Document Type : Original Article

Authors

1 Radiodiagnosis, Cairo university, Egypt

2 Radiodiagnosis department, hepatic institute.

Abstract

Background: Cervical and endometrial carcinomas, prevalent among gynecological cancers, often present with symptoms such as irregular vaginal bleeding and are typically diagnosed around the age of 50. The preoperative assessment plays a pivotal role in patient prognosis and survival.
Objective: This study aims to assess the effectiveness of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in preoperative staging and evaluation of endometrial and cervical carcinoma.
Methods: In this prospective study, 40 cases of uterine malignancy (20 endometrial carcinomas, 20 cervical carcinomas) were staged using T2WIs, DCE-MRI, and DWI after initial biopsy confirmation. Patients aged 32-76 presented with abnormal vaginal bleeding. The overall staging was correlated with surgical results using the revised FIGO system.
Results: In a study of 120 patients with uterine malignancies—60 with endometrial carcinoma and 60 with cervical carcinoma—distinct imaging characteristics were observed. Results indicated an overall accuracy of 75% for T2WIs, 85% for DCE-MRI, and 92.5% for DW-MRI in aligning with surgical staging and FIGO clinical staging.
Conclusion: The utilization of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) enhances the precision of diagnosing and staging cervical and endometrial cancers. This integration improves pre-surgical mapping, treatment response assessment, and outcome prediction.

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