{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:43:49Z","timestamp":1792115029322,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,19]],"date-time":"2018-11-19T00:00:00Z","timestamp":1542585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Grant-in-Aid for Scientific Research (C) of MEXT, Japan","award":["15K09915"],"award-info":[{"award-number":["15K09915"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although the prognosis of endometrial carcinoma (EMC) patients strictly depends on tumor invasion depth and its histologic grade, accurate preoperative assessment of these prognostic factors is often difficult.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the usefulness of diffusion\u2010tensor imaging (DTI) as a noninvasive method for evaluating tumor invasion depth and its histologic grade in patients with EMC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Twenty\u2010five consecutive patients with histologically confirmed EMC who were surgically treated at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>DTI was performed with a 1.5T MRI system using a single\u2010shot echo\u2010planar imaging sequence with b values of 0 and 1000 s\/mm<jats:sup>2<\/jats:sup> and motion\u2010probing gradients in nine noncollinear directions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD) maps were analyzed by three observers and compared with histopathologic findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Dunnett's test, Spearman's rank correlation coefficient, and receiver operating characteristic (ROC) curve analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FA maps from all patients distinctly identified the junctional zone as a high\u2010FA zone (0.864\u2009\u00b1\u20090.037) that was significantly different from the endometrium and outer myometrium (0.251\u2009\u00b1\u20090.030 and 0.471\u2009\u00b1\u20090.091, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). All EMCs were clearly depicted as hypointense areas on all DTI maps. AD maps provided the best tumor\u2010to\u2010uterus contrast, and EMCs (0.977\u2009\u00b1\u20090.120 \u00d7 10<jats:sup>\u22123<\/jats:sup> mm<jats:sup>2<\/jats:sup>\/s) had significantly lower AD values than all other layers of the normal uterine wall (2.166\u2009\u00b1\u20090.408, 2.010\u2009\u00b1\u20090.289, and 2.655\u2009\u00b1\u20090.203 \u00d7 10<jats:sup>\u22123<\/jats:sup> mm<jats:sup>2<\/jats:sup>\/s, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). EMCs were clearly demarcated from the normal uterine wall, and DTI maps and histopathologic data yielded identical findings regarding tumor invasion depth. FA values showed a significant inverse correlation (<jats:italic>r<\/jats:italic>\u2009=\u2009\u20130.818; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) with histologic grades 1, 2, and 3 of endometrioid adenocarcinomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>In patients with EMC, DTI may be useful for evaluating tumor invasion depth and its histologic grade.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 1<\/jats:p><jats:p><jats:bold>Technical Efficacy:<\/jats:bold> Stage 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019;50:250\u2013260.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26558","type":"journal-article","created":{"date-parts":[[2018,11,19]],"date-time":"2018-11-19T14:46:24Z","timestamp":1542638784000},"page":"250-260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Endometrial carcinoma: Evaluation using diffusion\u2010tensor imaging and its correlation with histopathologic findings"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-0836","authenticated-orcid":false,"given":"Ichiro","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, Graduate School Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimio","family":"Wakana","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Reproductive Medicine Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Human Pathology Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Miyasaka","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Reproductive Medicine Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Reproductive Medicine Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Wakabayashi","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Reproductive Medicine Tokyo Medical and Dental University  Tokyo 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