Myometrial invasion by endometrial carcinoma: assessment by MR imaging.

Sironi, Sandro; Taccagni, G; Garancini, Paola; Belloni, C; DelMaschio, A

doi:10.2214/ajr.158.3.1738995

Cited by 89 publications

(62 citation statements)

References 10 publications

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“…Pelvic MRI is an examination accepted in the characterisation of pelvic tumours due to its multiplanar capacity and its excellent resolution of soft tissue contrast (Cunha et al 2001;Sironi et al 1992a;Sironi et al 1992b). High accuracy in the assessment of the depth of myometrial infiltration (superficial/deep) as well as the extent of cervical invasion and identification of enlarged pelvic and para-aortic lymph nodes has been described in the literature (Cunha et al 2001;Manfredi et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and histopathologic evaluation

Vasconcelos

Félix²,

Cunha³

2007

Journal of Obstetrics and Gynaecology

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SummaryThis study aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in the detection of deep myometrial invasion and cervical extension by endometrial carcinoma. This prospective study included 101 patients with histologically documented endometrial carcinoma, between July 1998 and April 2004. The findings of preoperative pelvic MRI were compared with histological diagnosis. From 101 cases studied by pelvic MRI, 43 were classified as deep myometrial invasion (50% of myometrium), where the pathological evaluation confirmed as having deep myometrial invasion. Cervical extension in the MRI study was found in 19 cases. Pathologic study found cervical extension and/or invasion in 31 cases including all cases identified by MRI. The accuracy, sensitivity and specificity of MRI were 95%, 89%, 100%, detecting deep myometrial invasion and 88%, 61%, 100%, detecting cervical invasion, respectively. The high accuracy achieved makes MRI an adequate method for determine the depth of myometrial and cervical invasion in endometrial carcinoma.

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Section: Introductionmentioning

confidence: 99%

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and histopathologic evaluation

Vasconcelos

Félix²,

Cunha³

2007

Journal of Obstetrics and Gynaecology

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“…The reported accuracy of non-contrast-enhanced MR imaging for assessing the depth of myometrial invasion ranges between 74% and 97% (1,4,5,6,7,16,19). Hricak et al (1), in a prospective study of 88 patients, obtained an overall accuracy with MRI of 85%.…”

Section: Discussionmentioning

confidence: 99%

Endometrial carcinoma: Assessment of myometrial invasion with plain and gadolinium-enhanced MR imaging

Sáez

Urresola

Larena

et al. 2000

J. Magn. Reson. Imaging

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“…Interruption of the junctional zone with overlying intact myometrium implies superficial invasion, which is classified as stage Ib. Invasion of more than 50% of the myometrium with an intact outer rim is graded as a deep invasion, or stage Ic [27,30,31] (Table 1). Overestimation of tumor invasion can occur in cases with bulky masses that stretch and thin, rather than invade, the myometrium.…”

Section: Endometrial Cancermentioning

confidence: 99%

“…Most commonly, the tumor appears hypointense to the myometrium on early phase images. Superficial myometrial invasion is diagnosed when disruption of the inner myometrial enhancement is identified [32][33][34], whereas the diagnosis of deep myometrial invasion requires demonstration of focal thinning of the myometrium or evidence of direct tumor extension to the outer myometrium [30][31][32][33][34].…”

Section: Endometrial Cancermentioning

confidence: 99%

Widespread use of MRI in gynecology: a myth or reality?

Hricak

1997

Abdom Imaging

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It has been 15 years since magnetic resonance imaging (MRI) has been introduced into clinical practice. MRI of the central nervous system (CNS) and musculoskeletal system is flourishing. In the field of gynecology, the medical literature is flooded with evidence and support for the excellence of MRI and its superiority over other imaging modalities. Furthermore, the scientific data are complemented by cost-effectiveness studies to a much greater extent than that of CNS. National surveys, however, show that MRI of the female pelvis accounts for less than 4% of the MRI load nationwide. What are the reasons for this discrepancy between evidence and practice and how can it be corrected?1. Training and expertise: The vicious cycle of a paucity of clinical cases leads to lack of expertise. Therefore, only a few centers offer training. 2. Cost: There is a misconception about the high cost of MRI without the realization that a tailored, streamlined approach to the problem with a half-hour MR study may be all that is needed to obtain a specific diagnosis. Disease-driven protocols need to be developed including plane of section, type of sequence, and indications for the use of contrast media. 3. MRI in relation to ultrasound (US) or computed tomography (CT): MRI is not in competition with US. It is a valuable problem-solving approach often obviating surgery and guiding therapeutic decisions. In the evaluation of cancer of the vagina, cervix, or uterus, MRI should be used instead of, and not in addition to, CT. 4. Education: Referring physicians and third-party payors need to be informed and presented with evidence about not only the medical usefulness but also cost effectiveness of MRI. A more costly but practical approach that results in a precise diagnosis and eliminates a succession of less costly, inconclusive diagnostic examinations is cost effectiveness. Basic approach to imaging the female pelvisEssential imaging protocols for the female pelvis include axial T1-and T2-weighted images and sagittal T2-weighted images. Coronal images are not routinely needed but may add important information in selected cases. T2-weighted sequences (preferably fast spin-echo [FSE] T2-weighted images) are essential for the demonstration of normal anatomy and pathology. SE T1-weighted sequences are used to evaluate pelvic lymph nodes and to provide characterization of pathology involving the uterus and adnexa. If an adnexal lesion demonstrating high signal intensity on a T1-weighted sequence is identified, fat-saturation T1 imaging should be performed to differentiate between fat and blood. Contrast enhancement with gadolinium chelates is reserved primarily for the evaluation of ovarian and endometrial pathology. Flow-sensitive sequences, such as the gradient recalled echo technique, are sometimes needed to distinguish pelvic lymph nodes from vessels or to assess vascular patency. Respiratory compensation is used with all conventional SE sequences to reduce breathing artifact. Major clinical indications and MRI findingsMRI is currently u...

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Myometrial invasion by endometrial carcinoma: assessment by MR imaging.

Cited by 89 publications

References 10 publications

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and histopathologic evaluation

Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and histopathologic evaluation

Endometrial carcinoma: Assessment of myometrial invasion with plain and gadolinium-enhanced MR imaging

Widespread use of MRI in gynecology: a myth or reality?

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