Retrospective Assessment of Histogram-Based Diffusion Metrics for Differentiating Benign and Malignant Endometrial Lesions.

Objective: Our study aimed to retrospectively evaluate the utility of volumetric histogram-based diffusion metrics in differentiating benign from malignant endometrial abnormalities. Methods: A total of 54 patients underwent pelvic magnetic resonance imaging with diffusion-weighted imaging before endometrial tissue diagnosis. Two radiologists placed volumes of interest on the apparent diffusion coefficient (ADC) map encompassing the entire endometrium and focal endometrial lesions. The mean ADC, percentile ADC values, kurtosis, skewness, and entropy of ADC were compared between benign and malignant abnormalities. Results: In premenopausal patients, significant independent predictors of malignancy were whole-endometrium analysis for R1, 10th to 25th ADC percentile (P = 0.012); whole-endometrium analysis for R2, mean ADC (P = 0.001) and skewness (P = 0.004); focal lesion analysis for R1, skewness (P = 0.045); focal lesion analysis for R2, 10th to 25th ADC percentile (P

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