Endometrial carcinoma: efficacy of thin-section oblique axial MR images for evaluating cervical invasion

Shibutani, Osamu; Joja, Ikuo; Shiraiwa, Misaki; Asakawa, T.; Miyagi, Yasunari; Kudo, Takafumi; Hiraki, Yoshio

doi:10.1007/s002619900553

Cited by 29 publications

(17 citation statements)

References 21 publications

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“…As in the MRI evaluation GVI had lower accuracy on the evaluation of tumoral cervical extension. The obtained accuracy of 79% is in accordance with other series (22–24,39) .…”

Section: Discussionsupporting

confidence: 90%

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and gross visual inspection

Cunha¹,

Felix²,

Cabral

2001

Int J Gynecol Cancer

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This study aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in the detection of deep myometrial invasion and cervical extension by endometrial carcinoma. We also aimed to compare MRI results to surgical staging of endometrial carcinoma. Forty women with a histologic diagnosis of endometrial carcinoma underwent a preoperative pelvic MRI. In 33 cases intraoperative gross visual inspection (GVI) of the surgical specimen was also evaluated. The results obtained were compared with the histologic diagnosis. Pathologic evaluation of the myometrium determined that superficial invasion was present in 25 patients and deep invasion in 15. The uterine cervix was found to be involved in 12 cases. The accuracy, sensitivity, and specificity of MRI and GVI were 93%/91%, 80%/77%, and 100%/100%, respectively, in detecting deep myometrial invasion and 80%/79%, 33%/36% and 100%/100%, respectively, in determining cervical invasion. When the Kappa statistical measurement was applied, the results from each technique, MRI and GVI, showed an agreement on the evaluation of myometrial and cervical invasion by endometrial carcinoma. In conclusion, MRI, in this series, was demonstrated to be a reliable method for preoperative endometrial carcinoma "imagiological staging". The high accuracy achieved by MRI and GVI suggests that they may be used interchangeably.

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“…As in the MRI evaluation GVI had lower accuracy on the evaluation of tumoral cervical extension. The obtained accuracy of 79% is in accordance with other series (22–24,39) .…”

Section: Discussionsupporting

confidence: 90%

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and gross visual inspection

Cunha¹,

Felix²,

Cabral

2001

Int J Gynecol Cancer

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“…4). Axial oblique image orientation perpendicular to the cervical canal with thin section thickness will improve the assessment of cervical invasion in endometrial cancer [34]. Direct cervical stroma invasion may occur without invasion of the endocervical mucosa because of adjacent myometrial invasion.…”

Section: Criteria For Image Interpretation According To Tumor Stagementioning

confidence: 99%

Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging

et al. 2009

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The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution postcontrast images acquired at 2 min ± 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph nodespecific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer.

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“…The presence of macroscopic cervical infiltration implies a worse prognosis and necessitates a more radical surgery [3,14]. Our results demonstrated a sensitivity of 78%, a specificity of 83% and an accuracy of 81% in predicting the presence or absence of cervical involvement.…”

Section: Discussionmentioning

confidence: 61%

“…1a), as well as the presence of cervical infiltration (Fig. 1b) [13][14][15]. We used both standardized window settings (W: 350 HU, L: 50 HU) and narrow window settings (W: 250 HU, L: 100 HU) for the interpretation of the CT data, the latter to enhance the contrast between the tumor and the normally enhancing myometrium (Fig.…”

Section: Ct Techniquementioning

confidence: 99%

Local staging of endometrial carcinoma: role of multidetector CT

et al. 2008

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The purpose was to evaluate the accuracy of multidetector CT (MDCT) on a 16-row CT scanner in local staging of endometrial carcinoma and more specifically in the assessment of the depth of myometrial invasion and presence of cervical infiltration. This prospective study includes 21 women with newly diagnosed endometrial carcinoma. All CT examinations were performed on a 16-row CT scanner, and the protocol included scanning of the abdomen after intravenous administration of iodinated contrast material, during the portal phase, using a detector collimation of 16 x 0.75 mm and a pitch of 1.2. Sagittal, parasagittal and oblique reformatted images were evaluated for the depth of myometrial invasion, whether superficial or deep, and the presence of cervical infiltration. Imaging findings were correlated with the histopathologic results. The sensitivity, specificity and accuracy of MDCT in evaluating myometrial invasion were 100%, 80% and 95%, respectively, and for assessing cervical infiltration were 78%, 83% and 81%, respectively. In conclusion, MDCT on a 16-row CT scanner proved accurate in local staging of endometrial carcinoma.

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Endometrial carcinoma: efficacy of thin-section oblique axial MR images for evaluating cervical invasion

Abstract: Thin-section oblique axial MR images are considered to be useful for the assessment of cervical invasion by endometrial carcinoma.

Cited by 29 publications

References 21 publications

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and gross visual inspection

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and gross visual inspection

Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging

Local staging of endometrial carcinoma: role of multidetector CT

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