Junzhong Xu

Quantitative Time-Dependent Diffusion MRI for Diagnosis and Aggressiveness Assessment of Endometrial Cancer: A Prospective Study

Preoperative differentiation of benign and malignant endometrial lesions, along with the identification of aggressive histological types of endometrial cancer (EC), is crucial for guiding treatment strategies. Time-dependent diffusion magnetic resonance imaging (TDD-MRI), which allows the characterization of tissue microstructure at the cellular level, is not currently applied for endometrial lesions. This study aimed to evaluate TDD-MRI-derived microstructural parameters for noninvasively distinguishing benign and malignant endometrial lesions and predicting aggressive histological types of EC. This prospective study enrolled 177 patients with clinically suspected EC who underwent TDD-MRI between January 2024 and March 2025. The Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion method was used to extract microstructural parameters, including the cell diameter (d), intracellular volume fraction ( A total of 130 women (mean ± standard deviation age: 56 ± 14 years) administered uterine curettage or surgery were included in the final analysis. All microstructural parameters showed significant differences between benign endometrial lesions and EC ( TDD-MRI-derived microstructural parameters demonstrated high performance in differentiating benign from malignant endometrial diseases and identifying aggressive types of EC.