ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer

Gyn, Expert Panel on; Imaging, OB; Reinhold, Caroline; Ueno, Yoshiko; Akin, Esma A.; Bhosale, Priyadarshani R.; Dudiak, Kika M.; Jhingran, Anuja; Kang, Stella K.; Kilcoyne, Aoife; Lakhman, Yulia; Nicola, Refky; Pandharipande, Pari V.; Paspulati, Rajmohan; Shinagare, Atul B.; Small, William; Vargas, Hebert Alberto; Whitcomb, Bradford P.; Glanc, Phyllis

doi:10.1016/j.jacr.2020.09.001

Cited by 25 publications

(36 citation statements)

References 88 publications

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“…Despite its relatively high prevalence, the overall prognosis of EC is favorable with a worldwide low mortality rate estimated at 2.4% [2,3,7]. Approximately 82% of EC are diagnosed at an early stage of the disease, with abnormal vaginal bleeding or discharge being the initial symptom, which contributes to its global good prognosis [4].…”

Section: Introductionmentioning

confidence: 99%

“…The type II or estrogen-independent carcinomas account for 10% to 20% of EC and are composed of grade 3 endometrioid carcinoma and all non-endometrioid tumors. This type of tumor is less hormone-sensitive and generally more aggressive with a poorer prognosis than type I [6,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Although EC is surgically staged, it is important to identify the extent of the disease before surgery to optimize the best modality approach and treatment [7,8,10]. Preoperative imaging is helpful in patients with suspected extrauterine disease and allows the detection of locoregional advanced disease, identification of suspicious lymph nodes, and distant metastasis [7,11]. Cross-sectional imaging techniques are complementary modalities for surgical evaluation of EC [12] and play an important role both in the pretreatment and follow-up assessment of the disease [1,7].…”

Section: Introductionmentioning

confidence: 99%

“…Preoperative imaging is helpful in patients with suspected extrauterine disease and allows the detection of locoregional advanced disease, identification of suspicious lymph nodes, and distant metastasis [7,11]. Cross-sectional imaging techniques are complementary modalities for surgical evaluation of EC [12] and play an important role both in the pretreatment and follow-up assessment of the disease [1,7]. The central purpose of this manuscript is to review the role of imaging in high-risk endometrial cancer, particularly in diagnostic and staging assessment, and post-treatment surveillance of these patients.…”

Section: Introductionmentioning

confidence: 99%

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Role of Imaging in the Management of High-Risk Endometrial Cancer

Silva¹,

Carneiro²,

Cunha³

2021

Cureus

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Role of Imaging in the Management of High-Risk Endometrial Cancer

Silva¹,

Carneiro²,

Cunha³

2021

Cureus

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Whole‐tumor apparent diffusion coefficient histogram analysis for preoperative risk stratification in endometrial endometrioid adenocarcinoma

Ma,

Xu,

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo investigate the application of whole‐tumor apparent diffusion coefficient (ADC) histogram metrics for preoperative risk stratification in endometrial endometrioid adenocarcinoma (EEA).MethodsPreoperative MRI of 502 EEA patients were retrospectively analyzed. Whole tumor ADC histogram analysis was performed with regions of interest drawn on all tumor slices of diffusion‐weighted imaging scans. Risk stratification was based on ESMO‐ESTRO‐ESP guidelines: low‐, intermediate‐, high‐intermediate‐, and high‐risk. Univariable analysis was used to compare ADC histogram metrics (tumor volume, minADC, maxADC, and meanADC; 10th, 25th, 50th, 75th, and 90th percentiles of ADC [recorded as P10, P25, P50, P75, and P90 ADC, respectively]; skewness; and kurtosis) between different risk EEAs, and multivariable logistic regression analysis to determine the optimal metric or combined model for risk stratifications. Receiver operating characteristic curve analysis with the area under the curve (AUC) was used for diagnostic performance evaluation.ResultsA decreasing tendency in multiple ADC values was observed from the low‐ to high‐intermediate‐risk EEAs. The (low + intermediate)‐risk EEAs and low‐risk EEAs had significantly smaller tumor volumes and higher minADCs, meanADCs, P10, P25, P50, P75, and P90 ADCs than the (high‐intermediate + high)‐risk EEAs and non‐low‐risk EEAs (all P < 0.05), respectively. The combined models of the (meanADC + volume) and the (P75 ADC + volume) yielded the largest AUCs of 0.775 and 0.780 in identifying the (low + intermediate)‐ and the low‐risk EEAs from the other EEAs, respectively.ConclusionWhole‐tumor ADC histogram metrics might be helpful for preoperatively identifying low‐ and (low + intermediate)‐risk EEAs, facilitating personalized therapeutic planning.

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Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

Kido,

Himoto,

Kurata

et al. 2023

Magnetic Resonance Imaging

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The staging of endometrial cancer is based on the International Federation of Gynecology and Obstetrics (FIGO) staging system according to the examination of surgical specimens, and has revised in 2023, 14 years after its last revision in 2009. Molecular and histological classification has incorporated to new FIGO system reflecting the biological behavior and prognosis of endometrial cancer. Nonetheless, the basic role of imaging modalities including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography, as a preoperative assessment of the tumor extension and also the evaluation points in CT and MRI imaging are not changed, other than several point of local tumor extension. In the field of radiology, it has also undergone remarkable advancement through the rapid progress of computational technology. The application of deep learning reconstruction techniques contributes the benefits of shorter acquisition time or higher quality. Radiomics, which extract various quantitative features from the images, is also expected to have the potential for the quantitative prediction of risk factors such as histological types and lymphovascular space invasion, which is newly included in the new FIGO system. This article reviews the preoperative imaging diagnosis in new FIGO system and recent advances in imaging analysis and their clinical contributions in endometrial cancer.Evidence Level4Technical EfficacyStage 3

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ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer

Cited by 25 publications

References 88 publications

Role of Imaging in the Management of High-Risk Endometrial Cancer

Role of Imaging in the Management of High-Risk Endometrial Cancer

Whole‐tumor apparent diffusion coefficient histogram analysis for preoperative risk stratification in endometrial endometrioid adenocarcinoma

Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

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