Intravoxel incoherent motion diffusion-weighted imaging in differentiating uterine fibroid from focal adenomyosis: initial results

To evaluate the performance of intravoxel incoherent motion (IVIM)-diffusion-weighted imaging (DWI) in differentiating uterine fibroids from focal adenomyosises. Twenty-five uterine fibroids and 21 focal adenomyosises prospectively underwent IVIM-DWI examination prior to surgery. Four parameters including apparent diffusion coefficient total values (ADCtot), true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) derived from IVIM-DWI images were separately calculated and compared across four groups. There was a statistically significant difference in IVIM-derived f parameter between fibroid and focal adenomyosis (p = 0.01) and control group (p = 0.02). Uterine fibroids gave higher coefficient of variation (CV) of all IVIM-derived parameters than focal adenomyosises. IVIM-DWI could improve the sensitivity and specificity of detecting focal adenomyosis to 100 and 92.6 %, respectively. IVIM-f parameter could be potentially used to better distinguish uterine fibroid from focal adenomyosis. The higher CV of IVIM-derived parameters with acceptable range is often observed in the diseased group.