T2 relaxometry mapping in demonstrating layered uterine architecture: parameter optimization and utility in endometrial carcinoma and adenomyosis: a feasibility study

Abstract

Thinning and irregularity of the myometrial fourth layer in cases of endometrial malignancy might help in identification of superficial myoinvasion-this might be a new imaging armamentarium in nulliparous females where uterine preservation might be a consideration. The T₂ relaxation times of the myometrium and endometrium described here will help optimize the time to echo for the acquisition of MSE for relaxometry of the female pelvis. Advances in knowledge: Thinning and irregularity of the fourth myometrial layer helps in the identification of superficial myometrial invasion with a greater confidence and helps triage patients for uterine preservation when necessary. T₂ relaxometry might be undertaken in those nulliparous women with endometrial carcinoma in whom demonstration of no myometrial invasion will make them candidates for uterine preservation. Thickening of the fourth myometrial layer in adenomyosis requires further evaluation in a larger cohort of patients as an additional imaging finding. T₂ relaxation times of endometrial carcinoma is different from the normal endometrium in the three cases imaged, thus, further studies evaluating the T₂ values in a larger cohort might help in differentiating diseased from the healthy endometrium. T₂ time of the pelvic tissue described in the study will help select the time to echoes for MSE imaging of the female pelvis in further studies.