IDIOPATHIC ADULT COLO- COLIC INTUSSUSCEPTION ABSTRACT ID : IRIA - 1181.
ABSTRACT ID NO: IRIA - 1085 ROLE OF DIFFUSION WEIGHTED IMAGING IN UTERINE AND CERVICAL LESIONS.
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Transcript of ABSTRACT ID NO: IRIA - 1085 ROLE OF DIFFUSION WEIGHTED IMAGING IN UTERINE AND CERVICAL LESIONS.
ABSTRACT ID NO: IRIA - 1085
ROLE OF DIFFUSION WEIGHTED IMAGING IN UTERINE AND CERVICAL LESIONS
Increasingly used in abdomen and pelvis since the last decade
DWI ADC(Apparent Diffusion Coefficient) Cellularity
Increased Cellularity Impeded diffusion
INTRODUCTION
REVIEW OF LITERATURE
Role of diffusion weighted imaging in the diagnosis of gynecological diseases : Tomohiro Namimoto,Kazuo Awai,Takeshi Nakaura,Yumi Yanaga :
European Society of Radiology 2008
Important cancer biomarker
Aids in superior lesion characterization, tumor staging, treatment planning, and disease follow-up of gynaecological tumors
Help predict and assess treatment response earlier than other techniques
Can detect residual / recurrent tumor
REVIEW OF LITERATURE
Diffusion-weighted Imaging of Gynecologic Tumors: Diagnostic Pearls and Potential Pitfalls : Sunita Dhanda, et al
Radiographics 2014 :34:1393–1416
To assess role of Diffusion weighted imaging (DWI) in differentiating benign from malignant lesions of uterus and cervix
AIM
24 patients with uterine and cervical lesions15 control patients with normal uterus and cervixDWI with b value 800 as a part of routine MR imaging on 1.5T MRIApparent diffusion coefficient (ADC) calculated and correlated with histopathologyInclusion criteria: Patients with lesions of uterus and cervix who have undergone MRI and who have HPE follow up Exclusion criteria: Patients who have contraindications to MR imaging and who have no HPE follow up
MATERIALS AND METHODS
Name
Age
Hospital No
Date Of MRI Study
Clinical History
Previous USG,CT,MRI findings
Findings at MRI with special emphasis on DWI
Clinical Follow Up
HPE Diagnosis
PROFORMA
PATHOLOGIES
(n=2)
(n=12)
(n=5)
(n=5)
CARCINOMA ENDOMETRIUM
T2 WI
ADC :0.648x10-3mm2/s
DWIADC
F/65, Post menopausal bleeding
CARCINOMA ENDOMETRIUM
ADC 0.712 x10-3mm2/s
T2 WI
DWIADC
F/52, Menorrhagia
ADC :Normal Endometrium
S.NO. CONTROL ADC VALUES (X 10-3mm2/s)
1. 1.42
2. 1.29
3. 1.33
4. 1.43
5. 1.59
6. 1.45
7. 1.34
8. 1.46
9. 1.42
10. 1.42
11. 1.47
12. 1.59
13. 1.42
14. 1.49
15. 1.41
S.No ADC VALUES (X 10-3mm2/s)
1. 1.29
2. 0.712
3. 0.619
4. 0.94
5. 0.981
Range: 1.29 to 1.59 x 10-3mm2/sMean ADC : 1.44 x 10-3 mm2/s
Range :0.619 to 1.29 x 10-3mm2/s Mean ADC : 0.88 x 10-3mm2/s
ADC :Ca Endometrium
NPAR TESTSMANN-WHITNEY TEST
RANKS TEST STATISTICS
a. Grouping Variable: ANN
b. Not corrected for ties
CARCINOMA CERVIX
T2 WI
ADC:0.923x10-3mm2/s
DWI ADC
F/57Post menopausal bleeding
CARCINOMA CERVIX
ADC 0.977 x 103mm2/s
T2 WI
DWIADC
F/57 ,White discharge
ADC values of normal cervix
S.No CONTROL ADC VALUES X 10-3mm2/S
1 1.35
2 1.373 1.404 1.565 1.426 1.467 1.378 1.369 1.3410 1.3611 1.4312 1.3713 1.3614 1.3215 1.37
S.No ADC VALUES X 10-3mm2/S
1 0.618
2 1.104
3 0.886
4 1.012
5 0.977
Range :1.32 to 1.56 x10-3mm2/sMean ADC : 1.39 x10-3mm2/s
Range :0.618 to 1.012 x10-3mm2/sMean ADC :0.909 x10-3mm2/s
ADC values of Carcinoma cervix
NPAR TESTSMANN-WHITNEY TEST
RANKS TEST STATISTICS
b. Not corrected for ties.
a. Grouping Variable: ANN
LEIOMYOMA
T2 WI
ADC:1.616 x10-3mm2/s
DWIADC
F/43,Menorrhagia,dysmenorrhoea
LEIOMYOMAS
T2 WI
ADC: 1.256 x10-3mm2/s
DWIADC
F/43Menorrhagia
ADC values of normal myometrium
S.NO CONTROL ADC VALUES X 10-3mm2/s
1. 1.57
2. 1.39
3. 1.64
4. 1.68
5. 1.51
6. 1.54
7. 1.46
8. 1.54
9. 1.56
10. 1.52
11. 1.42
12. 1.54
13. 1.54
14. 1.53
15. 1.52
Range: 1.39 to 1.68 x10-3mm2/sMean ADC : 1.53 x10-3mm2/s
S.NO. ADC VALUES X 10-3mm2/s
1 2.27
2 1.77
3 1.59
4 1.53
5 1.54
6 1.206
7 1.828
8 2.059
9 1.616
10 1.256
11 2.1
12 1.41
ADC values of Leiomyoma
Range: 1.24 to 2.27 x10-3mm2/sMean ADC : 1.67x10-3mm2/s
STATISTICAL ANALYSIS :T-TEST
Independent Samples Test
Levene's Test for Equality of
Variances t-test for Equality of Means
F Sig. t dfSig. (2-tailed)
Mean Differe
nce
Std. Error
Difference
95% Confidence
Interval of the Difference
Lower UpperVALUES Equal
variances assumed
20.595 .000 -1.671 25 .107 -.14858
.08894 -.33176
.03459
Equal variances not assumed
-1.503 11.834 .159 -.14858
.09888 -.36436
.06720
STATISTICAL ANALYSIS (Cont…)
ADENOMYOSIS
ADC values of adenomyosis : 1.458 x 10-3mm/s and 1.506 x 10-3mm/s
T2 WI
DWIADC
F/40Dysmenorrhea,
ADC: 1.506 x10-3mm2/s
Significant reduction in ADC values of malignant lesions as compared to benign ones
Mean ADC of Ca Endometrium (0.88 x10-3mm2/s ) < Mean ADC of normal Endometrium (1.44 x10-3mm2/s )
Mean ADC of Ca Cervix (0.9 x10-3mm2/s) < Mean ADC of normal Cervix (1.39 x10-3mm2/s )
RESULTS
CONCLUSION
DWI with quantification of ADC values plays a major role in distinguishing benign and malignant lesions
DWI should be part of routine MR protocol when imaging the uterus and cervix
THANK YOU..