Diffusion-weighted imaging versus dynamic contrast-enhanced imaging for pre-operative diagnosis of deep myometrial invasion in endometrial cancer: A meta-analysis

• Published in: Clinical imaging Vol. 80; pp. 36 - 42
• Main Authors: Wang, Li-Jen, Tseng, Yi-Ju, Wee, Nicole Kessa, Low, Jeffrey Jen Hui, Tan, Cher Heng
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01.12.2021; Elsevier Limited
• Subjects: Accuracy; Bivariate analysis; Cancer; Collaboration; Confidence intervals; Deep myometrial invasion; Diagnosis; Diagnostic systems; Diffusion-weighted imaging; Dynamic contrast enhanced imaging; Endometrial cancer; Endometrium; Human subjects; Hysterectomy; Keywords; Libraries; Lymphatic system; Magnetic resonance imaging; Medical imaging; Meta-analysis; Metastasis; Myometrium; Reading; Statistical analysis; Subgroups; Systematic review; Tumors; Diffusion-weighted imaging; Deep myometrial invasion; Dynamic contrast enhanced imaging; Magnetic resonance imaging; Endometrial cancer; Meta-analysis
• ISSN: 0899-7071; 1873-4499; 1873-4499
• DOI: 10.1016/j.clinimag.2021.06.027

This study investigates the differences in diagnostic performance between diffuse-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE), either alone or in combination with T2-weighted imaging (T2WI), for diagnosing deep myometrial invasion (dMI) of endometrial cancers (EC). We performed a comprehensive search for published studies comparing DWI and DCE for preoperatively diagnosing dMI of EC. The overall diagnostic accuracy of each test was calculated using the areas under the summary receiver operating characteristic curves (AUCs). The sensitivities and specificities were compared using bivariate meta-regression. Pooled analysis of nineteen studies with 961 patients (main group) showed that DWI had a larger AUC (0.943, 95% confidence interval (CI) = 0.921–0.967) than DCE (0.922, 95% CI = 0.893–0.953). For the subgroup comprising 7 studies, DWI combined with T2WI and DCE combined with T2WI showed AUCs of 0.959 (95% CI, 0.932–0.986) and 0.929 (95% CI, 0.847–1.000), respectively. None of the differences in AUCs were statistically significant. All comparisons of the sensitivities and specificities of the main group and subgroup also showed no significant differences. This meta-analysis found no significant difference in diagnostic performance between DWI and DCE for diagnosis of dMI in EC. DWI may be preferred for its ease of use in clinical practice. •Assessing deep myometrial invasion in endometrial cancers can be performed with magnetic resonance imaging.•There was no significant difference in diagnostic performance between DWI and DCE-MRI for diagnosis of deep myometrial invasion in endometrial cancer.•Diffusion weighted imaging may be preferred for its ease of use in clinical practice.