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June 18, 2026

Utility of Single-Shot Fast Spin-Echo T2-Weighted MRI With Deep Learning Reconstruction for Assessing Myometrial Invasion in Endometrial Cancer

Key Points

To assess the feasibility of single-shot fast spin-echo T2-weighted MRI with deep learning reconstruction for evaluating myometrial invasion in endometrial cancer.
Retrospective analysis of 72 patients with endometrial cancer undergoing contrast-enhanced MRI.
Image quality assessed through SNR measurements and radiologist evaluations of SSFSE-DL-T2WI versus standard T2WI.
Diagnostic performance compared using ROC analysis with surgical pathology as reference.
SSFSE-DL-T2WI showed higher SNR but lower tumor-to-junctional zone contrast compared to standard T2WI (P<0.01).
Both methods showed comparable AUCs for myometrial invasion detection, with AUCs of 0.77 vs 0.72 for any invasion, and 0.86 vs 0.80 for deep invasion respectively.
SSFSE-DL-T2WI rated superior for image quality attributes like noise and tumor visibility by radiologists (P<0.01).

Abstract

OBJECTIVE: To evaluate the clinical feasibility of single-shot fast spin-echo T2-weighted MRI with deep learning reconstruction (SSFSE-DL-T2WI) for assessing myometrial invasion in endometrial cancer, compared with standard T2WI. MATERIALS AND METHODS: This retrospective study included 72 patients with endometrial cancer who underwent preoperative contrast-enhanced (CE) MRI. Standard T2WI was acquired using a para-axial fast spin-echo (FSE) sequence and a para-sagittal periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequence (mean acquisition time: 383 s). Para-axial and para-sagittal SSFSE-DL-T2WI were obtained with a mean acquisition time of 47 seconds. Signal-to-noise ratio (SNR) and tumor contrast were measured by one radiologist, whereas image quality was assessed by 2 radiologists. Comparisons between standard T2WI and SSFSE-DL-T2WI were performed using paired t tests or Wilcoxon signed-rank tests. Myometrial invasion was evaluated using T2WI alone and in combination with CE-T1WI. Diagnostic performance was evaluated using pathologic myometrial invasion in the surgical specimens as the reference standard and was compared between the 2 T2WI methods using receiver operating characteristic (ROC) analysis. RESULTS: SSFSE-DL-T2WI demonstrated significantly higher SNR but lower tumor-to-junctional zone contrast compared with FSE-T2WI (P<0.01). No significant differences in SNR or contrast were observed between SSFSE-DL-T2WI and PROPELLER-T2WI. Both readers rated SSFSE-DL-T2WI significantly better than standard T2WI with respect to noise, artifacts, and tumor visibility (P<0.01). The areas under the ROC curve (AUCs) for detecting any and deep myometrial invasion did not differ significantly between SSFSE-DL-T2WI (mean: 0.77 and 0.86, respectively) and standard T2WI (mean: 0.72 and 0.80, respectively). Similarly, when combined with CE-T1WI, AUCs were comparable between SSFSE-DL-T2WI (mean: 0.83 and 0.91, respectively) and standard T2WI (mean: 0.80 and 0.89, respectively). CONCLUSIONS: SSFSE-DL-T2WI provides superior image quality and comparable diagnostic accuracy for assessing myometrial invasion in endometrial cancer, while requiring substantially shorter acquisition time compared with standard T2WI.

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Cite This Study

Kiso et al. (Tue,) studied this question.

synapsesocial.com/papers/6a338e6e630953a74978f047 https://doi.org/https://doi.org/10.1097/rct.0000000000001896

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