Preoperative Magnetic Resonance Volumetry in Predicting Myometrial Invasion, Lymphovascular Space Invasion, and Tumor Grade: Is It Valuable in International Federation of Gynecology and Obstetrics Stage I Endometrial Cancer?

Şahin, Hilal; Sarıoğlu, Fatma Ceren; Bağci, Mustafa; Karadeniz, Tugba; Uluer, Hatice; Şancı, Muzaffer

doi:10.1097/igc.0000000000001208

Cited by 17 publications

(16 citation statements)

References 29 publications

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“…The absence of DMI is also part of the definition of low-risk group, so the difference between these two groups is statistically significant. However, this outcome is contrary to that of Sahin et al [18], who found that it was not statistically significant for tumor size, and tumor volume to predict tumor risk group. The clinical model, which was established by tumor size and DMI, yielded an AUC of 0.704 (95% CI 0.396-1) in the validation cohort.…”

Section: Discussioncontrasting

confidence: 99%

“…Several studies have explored the value of conventional MRI characteristics for preoperative risk stratification of EC [5,7,[16][17][18][19]. Lavaud et al [20] found that tumor size reflects tumor grade, histologic type and lymphatic vascular invasion in EC, and a diameter of 24 mm should be used to preoperatively classify the high-intermediate or high-risk groups of stage 1 EC.…”

Section: Discussionmentioning

confidence: 99%

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MRI-Based Radiomic Model for Preoperative Risk stratification in Stage I Endometrial Cancer

Chen¹,

Gu²,

Fan³

et al. 2021

J. Cancer

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

MRI-Based Radiomic Model for Preoperative Risk stratification in Stage I Endometrial Cancer

Chen¹,

Gu²,

Fan³

et al. 2021

J. Cancer

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“…Previous studies indicated a low specificity and accuracy of routine MRI in evaluating these risk factors. 13,14,[27][28][29] Positron emission tomography / computed tomography (PET/CT) did not reliably predict the high-risk EC for high false-negative rates. 30 However, the radiomics developed in this study might be helpful in identifying the risk factors of EC preoperatively, being consistent with preliminary studies using MRI-based texture analysis of small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…The challenge in preoperative staging and planning the surgical management of EC is the assessment of risk factors such as DMI, LNM, LVSI, etc. Previous studies indicated a low specificity and accuracy of routine MRI in evaluating these risk factors 13,14,27–29 . Positron emission tomography / computed tomography (PET/CT) did not reliably predict the high‐risk EC for high false‐negative rates 30 .…”

Section: Discussionmentioning

confidence: 99%

Preoperative Assessment for High‐Risk Endometrial Cancer by Developing an MRI‐ and Clinical‐Based Radiomics Nomogram: A Multicenter Study

Yan

Liu

Feng

et al. 2020

Magnetic Resonance Imaging

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Background: High-and low-risk endometrial cancer (EC) differ in whether lymphadenectomy is performed. Assessment of high-risk EC is essential for planning surgery appropriately. Purpose: To develop a radiomics nomogram for high-risk EC prediction preoperatively. Study Type: Retrospective. Population: In all, 717 histopathologically confirmed EC patients (mean age, 56 years AE 9) divided into a primary group (394 patients from Center A), validation groups 1 and 2 (146 patients from Center B and 177 patients from Centers C-E). Field Strength/Sequence: 1.5/3T scanners; T 2-weighted imaging, diffusion-weighted imaging, apparent diffusion coefficient, and contrast enhancement sequences. Assessment: A radiomics nomogram was generated by combining the selected radiomics features and clinical parameters (metabolic syndrome, cancer antigen 125, age, tumor grade following curettage, and tumor size). The area under the curve (AUC) of the receiver operator characteristic was used to evaluate the predictive performance of the radiomics nomogram for high-risk EC. The surgical procedure suggested by the nomogram was compared with the actual procedure performed for the patients. Net benefit of the radiomics nomogram was evaluated by a clinical decision curve (CDC), net reclassification index (NRI), and integrated discrimination improvement (IDI). Statistical Tests: Binary least absolute shrinkage and selection operator (LASSO) logistic regression, linear regression, and multivariate binary logistic regression were used to select radiomics features and clinical parameters. Results: The AUC for prediction of high-risk EC for the radiomics nomogram in the primary group, validation groups 1 and 2 were 0.896 (95% confidence interval [CI]: 0.866-0.926), 0.877 (95% CI: 0.825-0.930), and 0.919 (95% CI: 0.879-0.960), respectively. The nomogram achieved good net benefit by CDC analysis for high-risk EC. NRIs were 1.17, 1.28, and 1.51, and IDIs were 0.41, 0.60, and 0.61 in the primary group, validation groups 1 and 2, respectively. Data Conclusion: The radiomics nomogram exhibited good performance in the individual prediction of high-risk EC, and might be used for surgical management of EC. Level of Evidence: 4 Technical Efficacy Stage: 2

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“…Endometrial cancer (EC) is the fourth most common type of cancer and the most prevalent among the different female reproductive tract cancers (1, 2). While the five-year survival rate for EC is 85% for the stage I disease, the survival rate for stage IV is <17% (3).…”

Section: Introductionmentioning

confidence: 99%

The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

et al. 2020

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Background Diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) measurement provides additional information about tumor microstructure with potential relevance for staging and predicting aggressive disease in patients with endometrial cancer (EC). Purpose To determine whether ADC values in EC diverge according to the tumor’s histologic grade and myometrial invasion depth. Material and Methods A sample of 48 pathologically confirmed cases of EC were reviewed retrospectively. The sample was distributed as follows: G1 (n = 9); G2 (n = 18); G3 (n = 21); with myometrial invasion <50% (n = 31); and with myometrial invasion ≥50% (n = 17). DW images were performed at 3.0T with b factors of 0–1000/mm2. The region of interest (ROI) was defined within the tumor with T1-weighted and T2-weighted imaging and copied manually to an ADC map. The tumor’s grade and myometrial invasion’s depth were determined by postoperative histopathological tests. Results The means of ADCmin and ADCmean values were significantly lower for patients with G2 and G3 endometrial tumors than G1. The same tendency was observed in myometrial invasion, as both ADCmin and ADCmean values were lower for patients with deep than for those with superficial myometrial invasion. The cut-off values of the ADCmin and ADCmean that predicted high-grade tumors were 0.69 × 10−3 mm2/s and 0.82 × 10−3 mm2/s, respectively, while those for myometrial infiltration were 0.70 × 10−3 mm2/s (ADCmin) and 0.88 × 10−3 mm2/s (ADCmean). Conclusion ADCmin and ADCmean values correlated with histologic tumor grade and myometrial invasion depth; therefore, it is suggested that ADC on MRI may be a useful indicator to predict malignancy of ECs.

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Preoperative Magnetic Resonance Volumetry in Predicting Myometrial Invasion, Lymphovascular Space Invasion, and Tumor Grade: Is It Valuable in International Federation of Gynecology and Obstetrics Stage I Endometrial Cancer?

Cited by 17 publications

References 29 publications

MRI-Based Radiomic Model for Preoperative Risk stratification in Stage I Endometrial Cancer

MRI-Based Radiomic Model for Preoperative Risk stratification in Stage I Endometrial Cancer

Preoperative Assessment for High‐Risk Endometrial Cancer by Developing an MRI‐ and Clinical‐Based Radiomics Nomogram: A Multicenter Study

The apparent diffusion coefficient (ADC) on 3-T MRI differentiates myometrial invasion depth and histological grade in patients with endometrial cancer

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