Clinical Utility and Diagnostic Accuracy of Diffusion Weighted Imaging in Early Detection of Endometrial Carcinoma with Histopathological Concordance/Discordance: Experience of a Tertiary Care Hospital

Abstract

Objective: To evaluate the diagnostic accuracy of diffusion-weighted imaging (DWI) in the early detection of endometrial carcinoma, using histopathological findings as the gold standard.

Methodology: This prospective cross-sectional study was conducted at the Radiology Department of Dr. Ziauddin Hospital, Karachi, from December 27, 2019, to June 26, 2020. A total of 280 women aged 40–80 years presenting with abnormal uterine bleeding and thickened endometrium on ultrasound were included. All patients underwent pelvic MRI with diffusion-weighted sequences, followed by diagnostic dilatation and curettage (D&C) for histopathological correlation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using SPSS version 22.

Results: The average age of the patients was 59.17±9.0 years. Diagnostic accuracy of DWI-MRI was found to be 76.43% in diagnosis of endometrial carcinomas with sensitivity of 74.31%, specificity 78.68% PPV 78.68% and NPV 74.31% respectively.

Conclusion: DWI is a non-invasive, contrast-free, and cost-effective imaging modality that enhances diagnostic confidence in detecting endometrial carcinoma. When used in conjunction with conventional MRI sequences, it offers valuable information for preoperative staging and treatment planning, with diagnostic parameters closely aligned with histopathological outcomes.