Comparative analysis of the value of diffusion kurtosis imaging and diffusion-weighted imaging in evaluating the histological features of endometrial cancer.

PURPOSE: This study evaluated and compared the performances of diffusion kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) for diagnosing and histologically grading endometrial cancer.

MATERIALS AND METHODS: In this retrospective study, DKI and DWI data for 61 patients with endometrial cancer and 30 patients with a normal endometrium were analyzed, and the mean kurtosis (MK), mean diffusion coefficient (MD) and apparent diffusion coefficient (ADC) values for the endometrial cancer tissue and normal endometrial tissue were acquired. The parameters for the normal endometrium group (G0) and the endometrial cancer groups (G1, G2 and G3) were compared and analyzed. The receiver operating characteristic (ROC) curve was used to evaluate each parameter's diagnostic accuracy and threshold. Spearman correlation analysis was used to analyze the correlations between all parameters and histological grades.

RESULTS: The MK values for the G0, G1, G2 and G3 groups increased gradually, while the MD and ADC values decreased gradually. Except for the differences in the ADC values between G0 and G1, the differences among the groups were statistically significant (P < 0.05). The MK values had the highest diagnostic accuracy in differentiating G0 and (G1 + G2 + G3), G0 and G1, G1 and G2, and G2 and G3 (AUC = 0.93, 0.76, 0.91, 0.91, P < 0.05). MK was maximally correlated with histological grade, followed by MD and ADC (MK > MD > ADC; r = - 0.85, + 0.82, + 0.76, P < 0.01).

CONCLUSION: Both DKI and DWI can be used to evaluate the diagnosis and histological grading of endometrial cancer. Compared with DWI, the DKI model is a more complete mathematical model with more sensitive parameters, which can more effectively evaluate the pathological and physiological characteristics of endometrial cancer.