Quantitative diffusion-weighted magnetic resonance imaging of normal and diseased uterine zones

Kilickesmez, O. | Bayramoglu, S. | Inci, E. | Cimilli, T. | Kayhan, A.

Article | 2009 | Acta Radiologica50 ( 3 ) , pp.340 - 347

Background: Magnetic resonance (MR) imaging has been established as the best imaging modality for the detection, localization, and staging of uterine cancers. Recently, the usefulness of diffusion-weighted imaging (DWI) in the diagnosis of cancers has been reported in several studies. Purpose: To calculate the apparent diffusion coefficient (ADC) values of normal uterine zones as well as benign and malignant uterine diseases, and to determine a cut-off ADC value for the quantitative detection of uterine malignancies with DWI. Material and Methods: Eighty-seven patients (mean age 53 years) with 107 benign and malignant uterine pathol . . .ogies and 50 healthy controls (mean age 38 years) were enrolled in the study. DWI was performed with b factors of 0, 500, and 1000 s/mm2. Results: The ADC values of benign and malignant lesions were compared using Student's t test. The mean and the standard deviation of the ADC values of the control group were as follows: myometrium 1.760.1910-3 mm2/s, junctional zone 0.990.1810-3 mm2/s, endometrium 1.650.3310-3 mm2/s, and cervix 1.710.1710-3 mm2/s. There was a statistically significant difference among the ADC values of normal myometrium and leiomyomas (1.470.3610-3 mm2/s; P0.009), endometrium and endometrial carcinomas (0.860.1310-3 mm2/s; P0.001), myometrium-junctional zone and adenomyosis (1.240.2010-3mm2/s; P0.001), and cervix and cervical carcinomas (0.910.1410-3 mm2/s; P0.001). The ADC values differed significantly between malignant (0.880.11) and benign lesions (1.550.33; P0.01). A cut-off value for malignant lesions of 1.0510-3 mm2/s yielded a sensitivity, specificity, and accuracy of 95.83%, 94.55%, and 94.94%, respectively. Conclusion: The present study shows that ADC measurements have the potential to quantitatively differentiate between normal and cancerous tissues of the uterine zones. We propose adding DWI as an adjunct sequence in the MR protocol for the assessment of uterine lesions. © 2009 Informa UK Ltd Daha fazlası Daha az

Diagnostic utility of DTI in prostate cancer

Gürses, B. | Tasdelen, N. | Yencilek, F. | Kilickesmez, N.O. | Alp, T. | Firat, Z. | Gürmen, A.N.

Article | 2011 | European Journal of Radiology79 ( 2 ) , pp.172 - 176

Purpose: The aim of this study was to compare the diffusion tensor parameters of prostate cancer, prostatitis and normal prostate tissue. Materials and Methods: A total of 25 patients with the suspicion of prostate cancer were included in the study. MRI was performed with 3 T system (Intera Achieva, Philips Medical Systems, The Netherlands). T2 TSE and DTI with ss-EPI were obtained in each subject. TRUS-guided prostate biopsy was performed after the MRI examination. Images were analyzed by two radiologists using a special software system. ROI's were drawn according to biopsy zones which are apex, midgland, base and central zone on e . . .ach sides of the gland. FA and ADC values in areas of cancer, chronic prostatitis and normal prostate tissue were compared using Student's t-test. Results: Histopathological analysis revealed carcinoma in 68, chronic prostatitis in 67 and was reported as normal in 65 zones. The mean FA of cancerous tissue was significantly higher (p < 0.01) than the FA of chronic prostatitis and normal gland. The mean ADC of cancerous tissue was found to be significantly lower (p < 0.01), compared with non-cancerous tissue. Conclusion: Decreased ADC and increased FA are compatible with the hypercellular nature of prostate tumors. These differences may increase the accuracy of MRI in the detection of carcinoma and to differentiate between cancer and prostatitis. © 2010 Elsevier Ireland Ltd Daha fazlası Daha az

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