Assessment of Myometrial Invasion of Endometrial Carcinoma Using Fusion of T2WI and DWI Taking Histopathology as Gold Standard

Precise evaluation of myometrial invasion in endometrial carcinoma is crucial. MRI; especially combination of T2WI and DWI has shown great potential as non-invasive method for this assessment. Objective: To determine positive predictive value of T2WI and DWI fusion in diagnosis of deep myometrial invasion of endometrial carcinoma taking histopathology as gold standard. Methods: This cross sectional study was piloted on 71 patients recruited from Radiology and Gynaecology departments of SGRH, Lahore. All histologically confirmed cases of endometrial carcinoma underwent pelvic MRI, including T2WI and DWI were included. The fused T2WI-DWI images were evaluated for presence and depth of myometrial invasion. Final histopathology reports post-surgery were used as gold standard to determine the PPV of the fused approach. Results: The positive predictive value of T2WI-DWI for detecting deep myometrial invasion calculated is 94.4%. Conclusions: Current findings suggest that, fusion of T2WI and DWI proved to be highly effective tool in diagnosing deep myometrial invasion in cases of endometrial carcinoma, taken histopathology as gold standard. The results indicate that this combined imaging approach offers strong PPV and overall accuracy, supporting its use as reliable, non-invasive method for preoperative evaluation.