Endometrial carcinoma staging by MR imaging.

Hricak, Hedvig; Stern, Jeffrey L.; Fisher, Madeleine R.; Shapeero, Lorraine G.; Winkler, Marion F.; Lacey, Conley G.

doi:10.1148/radiology.162.2.3797641

Cited by 186 publications

(88 citation statements)

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“…MRI is a well-established imaging technique for the pre-operative evaluation of endometrial carcinoma [35,36]. However, conventional MRI sequences cannot differentiate between carcinoma, endometrial hyperplasia or benign polyps and histological confirmation is required [35].…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer

Bharwani

Miquel²,

Sahdev³

et al. 2011

BJR

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Objective: Endometrial cancer is the most common gynaecological malignancy in developed countries. Histological grade and subtype are important prognostic factors obtained by pipelle biopsy. However, pipelle biopsy ''samples'' tissue and a high-grade component that requires more aggressive treatment may be missed. The purpose of the study was to assess the use of diffusion-weighted MRI (DW-MRI) in the assessment of tumour grade in endometrial lesions. we obtained a sensitivity, specificity, positive predictive value and negative predictive value for malignancy of 87%, 100%, 100% and 85.7%, respectively. Conclusion: Tumour mean and minimum ADC values are not useful in differentiating histological tumour grade in endometrial carcinoma. However, mean ADC measurement can provide useful information in differentiating benign from malignant endometrial lesions. This information could be clinically relevant in those patients where pre-operative endometrial sampling is not possible.

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Section: Discussionmentioning

confidence: 99%

Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer

Bharwani

Miquel²,

Sahdev³

et al. 2011

BJR

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“…In stage IIA the internal os and the endocervical canal are widened by the hyperintense or inhomogeneous tumor signal at T2-weighted imaging or the hypointense tumor at contrast-enhanced imaging. If the low signal intensity ring of the normal cervical stroma is disrupted, stage IIB can be diagnosed [38,39] (Fig. 4).…”

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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“…Numerous studies have evaluated the use of MRI to assess the depth of myometrial invasion, and the reported accuracies have ranged from 71% to 97%. 9,10,12,14,22 To the best of our knowledge, a comparative study of the diagnostic accuracy between SH and MRI has not been reported previously. Our results showed that SH had sensitivity of 64.7%, specificity of 87.7%, a PPV of 61.1%, and an NPV of 89.3%, and the diagnostic performance of SH was comparable to that of MRI.…”

Section: Discussionmentioning

confidence: 94%

“…performing and reading SH and MRI was blinded to the results of each imaging modality to minimize the intraobserver bias. Myometrial invasion was defined as a poorly defined interface between the myometrium and endometrium on SH and MRI, and the depth of myometrial invasion was classified into 2 categories according to previously defined criteria 22,23 : (1) invasion of less than half of the myometrium (<50% or superficial) and (2) invasion of half of the myometrium or more (≥50% or deep). The accuracy of SH and MRI in evaluation of myometrial invasion was assessed in comparison with the histopathologic findings (Figures 1 and 2).…”

Section: Methodsmentioning

confidence: 99%

Value of Sonohysterography in Preoperative Assessment of Myometrial Invasion for Patients With Endometrial Cancer

Chang

Lee

Kim

et al. 2010

Journal of Ultrasound in Medicine

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Objective. The aims of this study were to compare the diagnostic performance of sonohysterography (SH) with that of magnetic resonance imaging (MRI) in estimation of myometrial invasion and to evaluate the influence of SH on peritoneal cytologic results for patients with endometrial cancer. Methods. Seventy-four patients with endometrial cancer were included. Sonohysterography and MRI were performed before surgery. All patients had complete staging procedures, including peritoneal cytologic analyses. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for SH and MRI. Results. The concordance rates of myometrial invasion for SH and MRI were 82.4% and 81.1%, respectively. The sensitivity, specificity, PPV, and NPV for identification of deep myometrial invasion were 64.7%, 87.7%, 61.1%, and 89.3% on SH and 70.6%, 84.2%, 57.1%, and 90.6% on MRI. Two patients (2.7%) were found to have positive results for malignant cells on peritoneal cytologic analyses. Conclusions. Sonohysterography appears to be a useful preoperative method for predicting myometrial invasion, comparable to MRI.

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Endometrial carcinoma staging by MR imaging.

Cited by 186 publications

References 0 publications

Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer

Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer

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

Value of Sonohysterography in Preoperative Assessment of Myometrial Invasion for Patients With Endometrial Cancer

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