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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0045-1809903
Original Article

The Role of Apparent Diffusion Coefficient in Differentiating Benign and Malignant Endometrial Pathologies: A Prospective Single-Center Study

Poonam Sherwani 
1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
,
Khanak Nandolia 
2   Department of Radiodiagnosis, All India Institute of Medical Sciences Rajkot, Rajkot, Gujarat, India
,
Latika Chawla 
1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
,
Arvind Kumar 
4   Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
,
Anjum Syed 
5   Department of Radiodiagnosis, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
,
Ranjeeta Kumari 
6   Department of Community Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
› Institutsangaben
Funding None.
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Abstract

Purpose

To investigate the added role of apparent diffusion coefficient (ADC) in differentiating benign from malignant pathologies.

Materials and Methods

Hospital-based random sampling was done and all the females with clinical details suggestive of endometrial pathologies and abnormal ultrasound underwent contrast-enhanced magnetic resonance imaging (MRI). In addition to the routine sequences, imaging was done at different b-values and ADC was calculated. The higher the ADC value the more the chances of benignity. Dynamic contrast-enhanced imaging was also done. Two radiologists with 18 and 10 years of experience evaluated the imaging findings and interobserver agreement was also made. Imaging findings were correlated with diagnosis as made by endometrial aspirate biopsy, dilatation–curettage, or postoperative histopathological examination.

Results

The addition of ADC value and dynamic contrast-enhanced MRI showed a significant role in differentiating benign from malignant conditions. The mean ADC measurement in malignant lesions was 0.88 × 10−3 ± 0.27 × 10−3, whereas the mean ADC measurement for benign lesions was 1.03 × 10−3 ± 0.38 × 10−3. The differences between the two were found to be significant (t-value: 2.754, p-value: 0.014). The cutoff of mean ADC and minimum ADC with the highest sensitivity and specificity were reported to be ≤1 × 10−3 and ≤0.8 × 10−3, respectively.

Conclusion

Adding the ADC value with routine magnetic resonance sequences plays a significant role in differentiating between benign and malignant endometrial pathologies, especially in indeterminate cases

Keywords

apparent diffusion coefficient - endometrium - histopathology - magnetic resonance imaging

Data Availability Statement

Data are available and will be available on reasonable request.


Authors' Contributions

P.S.: concept and final editing of the manuscript; K.N.: drafting of the manuscript and the images; L.C.: clinical inputs; A.K.: final pathology and providing pathology images; A.S.: drafting of the manuscript; R.K.: statistical analysis




Publikationsverlauf

Artikel online veröffentlicht:
24. Juni 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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