DIAGNOSTIC ACCURACY OF DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING IN DETECTING DEEP MYOMETRIAL INVASION BY ENDOMETRIAL TUMOR TAKING HISTOPATHOLOGY AS GOLD STANDARD

Objective: To evaluate the diagnostic accuracy of DW-MRI in detecting deep myometrial invasion in endometrial carcinoma, using histopathology as the reference standard. Methods: This cross-sectional validation study was conducted at the Department of Radiology, Hayatabad Medical Complex, Peshawar, from January to June 2023. A total of 124 women (aged 30–70 years) with biopsy-proven endometrial carcinoma scheduled for hysterectomy were enrolled. DW-MRI findings were interpreted by an experienced radiologist and compared with postoperative histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. Results: DW-MRI demonstrated a sensitivity of 81.5% (95% CI: 72.1–88.9%) and a specificity of 87.5% (95% CI: 71.0–96.5%) in detecting deep myometrial invasion. The positive predictive value was 94.9%, and the negative predictive value was 62.2%, with an overall diagnostic accuracy of 83.1%. Performance was superior in postmenopausal women and low-grade tumors. Conclusion: DW-MRI exhibits high diagnostic accuracy in assessing deep myometrial invasion in endometrial carcinoma, supporting its role as a reliable preoperative imaging modality. Its non-invasive nature and high reproducibility make it a valuable tool in clinical practice.