The Combination of Diffusion- and T2-Weighted Imaging in Predicting Deep Myometrial Invasion of Endometrial Cancer: A Systematic Review and Meta-Analysis

Objective The aim of this study was to explore the diagnostic difference among the combination of diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in predicting deep myometrial invasion of endometrial cancer. Methods A structured search was conducted to identify published studies between January 2005 and April 2014, which assessed depth of myometrial invasion in endometrial cancer by using DCE-MRI or DWI or DWI-T2WI. Results A total of 15 studies were included. Significant difference was found between DWI-T2WI and DWI in pooled specificity, and also in comparison between DCE-MRI and DWI-T2WI (P < 0.05). In summary, receiver operating characteristic analysis, area under the curve for DWI-T2WI, DWI, and DCE-MRI were 0.94, 0.90, and 0.93, respectively. Conclusions Diffusion-weighted imaging-T2WI can improve diagnostic performance in comparison with DWI alone. Meanwhile, DWI-T2WI performs better than DCE-MRI in predicting myometrial invasion of endometrial cancer. It may be an alternative for DCE-MRI in presurgical staging of endometrial cancer.