Contrast-enhanced three-dimensional MR imaging using T 1-weighted high-resolution isotropic volume examination (THRIVE): Focus on endometrial cancer

The present study sought to provide optimized radiographic information regarding endometrial cancer by comparing dynamic contrast-enhanced images obtained using the 3-dimensional T (1)-weighted high-resolution isotropic volume examination (3D-THRIVE) technique to existing 2-dimensional magnetic resonance (MR) images to provide data regarding the radiological advantages and the technical aspects of 3D-THRIVE. This study included 30 patients with suspected endometrial cancer who were referred for an MR exam for disease characterization and staging. A 3.0T MR scanner was used to obtain 2D turbo spin echo (2D-TSE) images prior to injection of the contrast medium. After the injection, 3D-THRIVE images and 2D spectral pre-saturation inversion recovery (2D-SPIR) images were obtained. The imaging methods were quantitatively compared using the signal-to-noise ratios (SNRs) of the uterus and the endometrial cancer, the contrast-to-noise ratio (CNR) between tissue pairs, and the time-intensity curve. Comparative qualitative analyses were also conducted using an MR image evaluation tool. Comparison of the pre- and post-contrast enhancement images showed that the SNRs measured from the uterus and the endometrial cancer (SNR (uterus) and SN R (ec) ) were relatively higher and more optimized for the contrast-enhanced 3D-THRIVE and 2D-SPIR images than they were for the pre-contrast 2D-TSE images (p < 0.05). Comparison of the images after contrast enhancement showed that the SNR (ec) value was higher for the 2D-SPIR image than for the 3D-THRIVE image. The CNR (ec/uterus) value was higher for the 3D-THRIVE image than for the 2D-SPIR image (p > 0.05). The time-intensity curve was obtained with the 3D-THRIVE sequence and provided data that enabled a differentiation between malignant tumors and normal tissue. The overall image quality, artifacts, and lesion definition and representation were superior for contrast-enhanced 3D-THRIVE images compared to pre- and post-contrast enhancement of 2D-TSE and 2D-SPIR images (p < 0.05). In conclusion, 3D-THRIVE images had better image quality than 2D-TSE and SPIR images. In addition to 3D-THRIVE being an alternative to 2D-TSE and SPIR in terms of endometrial cancer characterization and staging, it also provides superior data for the differentiation between malignant tumors and normal tissue.