Objective This study aimed to elucidate the difference in diffusion-weighted magnetic resonance imaging (DWI) and diffusion tensor imaging (DTI) parameters between endometrioid endometrial adenocarcinoma (EEA) and uterine serous adenocarcinoma (SA).

Methods Data of patients with pathologically confirmed EEA or SA who underwent DWI and DTI scanning between May 2013 and July 2016 were retrospectively analyzed. Apparent diffusion coefficient (ADC) value from DWI and ADC from DTI (ADC^T) map and fractional anisotropy (FA) values from DTI were analyzed and compared statistically. The correlation between ADC and ADC^T was analyzed by Pearson correlation analysis. Apparent diffusion coefficient, ADC^T, and FA between the 2 groups were compared using independent t test. The effect of ADC, ADC^T, and FA in distinguishing EEA and SA was evaluated by receiver operator characteristic curve.

Result Thirty-three patients were enrolled into the study, including 13 cases of SA and 20 cases of EEA. Pearson correlation analysis suggested that the value of ADC was highly related with ADC^T in both the SA group (r = 0.812, P = 0.001) and the EEA group (r = 0.858, P < 0.001). The value of ADC and ADC^T in the SA group was significantly lower than that in the EEA group; FA was significantly higher than that in the EEA group. Receiver operator characteristic curve analysis showed that ADC and ADC^T have high sensitivity and specificity; FA has low sensitivity and high specificity.

Conclusions We suggest that both DWI and DTI could be used in distinguishing EEA from SA. Apparent diffusion coefficient and ADC^T possess potential diagnostic value with high sensitivity and specificity.