3D-T2 weighted imaging in female pelvis on 3T MRI: Assessment of the usefulness and its limitation
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1 3D-T2 weighted imaging in female pelvis on 3T MRI: Assessment of the usefulness and its limitation Poster No.: C-1331 Congress: ECR 2010 Type: Educational Exhibit Topic: Genitourinary - Kidney Authors: J. Takahama, S. Kitano, A. Takahashi, S. Miura, N. Marugami, M. Takewa, T. Itoh, K. Kichikawa; Kashihara City/JP Keywords: Uterine coupus cancer, MRI, 3D images Keywords: Kidney DOI: /ecr2010/C-1331 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 20
2 Learning objectives To illustrate the spectrum of 3D-T2 weighted images on 3T MRI of gynecological lesions. To outline the advantages and limits of the technique comparing with 2D-T2Wi on 3T MRI and 3D-T2Wi on 1.5T MRI. To describe the best indications and results of the method based on a series of malignant uterine lesions on 3T MRI. Page 2 of 20
3 Background Uterine malignant tumors are required accurate diagnosis of local invasion. MRI is useful tool and standard guideline had already presented by European Society of Urogenital Radiology, in which they emphasize the necessity of oblique images on T2Wi. In this exhibits, we will describe the usefulness of 3D-T2 weighted images on 3T MRI imaging, that make easy to observe multi planar reformat images. For the results, the advantages and the limits of this technique compared to the ordinal 2D-T2Wi on 3T and 3D-T2Wi that obtained by 1.5T. The technique, indications and contraindications are described and illustrated. Page 3 of 20
4 Imaging findings OR Procedure details Procedure details; Trained a reader analyzed images. On Magnetom Verio 3T (Siemens), 3D-T2WI (SPACE: TR/TE=2700/287, PAT=2, Slice thickness=1.0mm) 2D-T2WI (FSE: TR/TE=4000/93, Slice thickness=3.0mm,) and On Avanto 1.5T 3D-T2WI (SPACE:TR/TE=2500/138 PAT=2, Slice thickness=1mm) Patients; # 14 patients at 3T MRI endometrial adenocarcinoma 2 cervical cancer 2 ovarian cancer 4 leiomyoma 3 normal 3 # 17 patients at 1.5 T MRI leiomyoma 10 endometrial adenocarcinoma 5 endometrial benign lesions 2 Imaging findings Quantity analysis CNR endometrium(em)/myometrium(my), EM/junctional zone(jz) Lesion/MY Quality analysis Page 4 of 20
5 Contrast of the anatomical structure Poor, moderate, fair Contrast of the lesions Poor, moderate, fair Results CNR showed no interval changes between 2D and 3D T2WI. For the quality analysis, 3T MRI is good enough to substitute conventional 2D T2WI though 1.5 T MRI has some disadvantage in lesion contrast. Page 5 of 20
6 Images for this section: Fig. 0 Page 6 of 20
7 Fig. 0 Page 7 of 20
8 Fig. 0 Page 8 of 20
9 Fig. 0 Page 9 of 20
10 Fig. 3: Uterine corpus cancer Ia on 3D-T2WI at 3T. Page 10 of 20
11 Fig. 0: Corpus cancer stage Ia at 3.0T. MPR was observed on viewer. Page 11 of 20
12 Fig. 2: Corpus cancer Stage Ia on 3D-T2 weighted images at 3T. MPR obtained oblique images. Page 12 of 20
13 Fig. 0: Corpus cancer stage Ic at 1.5 T. MPR was observed on viewer. Page 13 of 20
14 Fig. 1: Copus cancer Ic at 1.5 T. MPR for oblique images. Fig. 0 Page 14 of 20
15 Fig. 0 Page 15 of 20
16 Fig. 0 Page 16 of 20
17 Conclusion 3D-T2Wi is considered enable to replace in uterine malignant lesions on 3T-MRI and superior to 3D-T2Wi on 1.5T MRI. Though bowel motion artifact and limitation of scan range is the problematic, 3D-T2Wi on 3T-MRI was useful in staging with of satisfactory results. Page 17 of 20
18 Personal Information Page 18 of 20
19 References 1. Hricak H, Stern JL, Fisher MR, Shapeero LG, Winkler ML, Lacey CG. Endometrial carcinoma staging by MR imaging. Radiology 1987; 162: Van Hoe L, Vanbeckevoort D, Oyen R, Itzlinger U, Vergote I. Cervical carcinoma: optimized local staging with intravaginal contrast-enhanced MR imaging--preliminary results. Radiology 1999; 213: Tanaka YO, Nishida M, Tsunoda H, Ichikawa Y, Saida Y, Itai Y. A thickened or indistinct junctional zone on T2-weighted MR images in patients with endometrial carcinoma: pathologic consideration based on microcirculation. Eur Radiol 2003; 13: Manfredi R, Mirk P, Maresca G, et al. Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology 2004; 231: Takeuchi M, Matsuzaki K, Uehara H, Yoshida S, Nishitani H, Shimazu H. Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol 2005; 15: Brown MA, de Abreu HR. MR imaging of malignant uterine disease. Magn Reson Imaging Clin N Am 2006; 14: , v-vi. 7. Kinkel K. Pitfalls in staging uterine neoplasm with imaging: a review. Abdom Imaging 2006; 31: Chung HH, Kang SB, Cho JY, et al. Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol 2007; 104: Hricak H, Gatsonis C, Coakley FV, et al. Early invasive cervical cancer: CT and MR imaging in preoperative evaluation - ACRIN/GOG comparative study of diagnostic performance and interobserver variability. Radiology 2007; 245: Koyama T, Tamai K, Togashi K. Staging of carcinoma of the uterine cervix and endometrium. Eur Radiol 2007; 17: Cabrita S, Rodrigues H, Abreu R, et al. Magnetic resonance imaging in the preoperative staging of endometrial carcinoma. Eur J Gynaecol Oncol 2008; 29: Charles-Edwards EM, Messiou C, Morgan VA, et al. Diffusion-weighted imaging in cervical cancer with an endovaginal technique: potential value for improving tumor detection in stage Ia and Ib1 disease. Radiology 2008; 249: Page 19 of 20
20 13. Fujii S, Matsusue E, Kigawa J, et al. Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results. Eur Radiol 2008; 18: Hori M, Kim T, Murakami T, et al. Uterine cervical carcinoma: preoperative staging with 3.0-T MR imaging--comparison with 1.5-T MR imaging. Radiology 2009; 251: Page 20 of 20
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