The accuracy of magnetic resonance imaging for preoperative deep myometrium assessment in endometrial cancer

Wu, Wan‐Ju; Yu, Mu-Shein; Su, Her-Young; Lin, Ke-Shin; Lu, Kaili; Hwang, Kuei-Shuei

doi:10.1016/j.tjog.2013.04.010

Cited by 17 publications

(20 citation statements)

References 16 publications

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“…Negative predictive value of cervical invasion and nodal invasion was high in this study but accuracy for myometrial invasion was low with higher sensitivity and lower specificity than quoted in literature. 22 While many studies in the literature quote high accuracy rates for myometrial invasion, Anderson et al and Rockall et al have reported similar rates of accuracy for these parameters as in our study with specificity and negative predictive value for cervical invasion and nodal invasion being in the range of 75-98% . 23,24…”

Section: Discussionsupporting

confidence: 83%

Early oncological outcomes and accuracy of risk stratification and tailoring surgical staging based on preoperative histology, Ca125 and MRI in endometrial cancer: a prospective cohort study

Mathews

Abraham

2019

Int J Reprod Contracept Obstet Gynecol

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Background: momentum to select patients who will benefit from the extensive procedures. However, the parameters used for risk stratification have variable accuracy outside of tertiary cancer centres. This study looks into the accuracy of risk stratification using preoperative histology, MRI and Ca 125 levels and the oncological outcomes after tailoring surgical staging based on the risk stratification by combining the three variables in a suburban centre with a growing cancer population.Methods: This prospective observational cohort study was undertaken in a suburban cancer center in Pushpagiri Medical College, Tiruvalla, Kerala between June 2014 and December 2018. All patients underwent surgical staging with hysterectomy and salpingo oophorectomy as the least procedure. Lymphadenectomy was tailored according to the preoperative risk grouping and changed only in the presence of gross findings at surgery. Adjuvant treatment and follow up data obtained and collected in Microsoft Excel and analysed using statistical software SPSS version 22.Results: Of 47 patients recruited for the study, 35 patients were available for final analysis. Preoperative histology was accurate in 73%. There was 20 % overestimation and 8% underestimation. Ca 125 levels were elevated in 15%. MRI had an overall sensitivity of 74% and specificity of 60%. When MRI, Ca125 and histology were combined together, there was patients were deemed to be high risk. On final risk grouping, 9 patients were down staged and none were upstaged.Conclusions: Preoperative histology, MRI and ca 125 levels have moderate accuracy individually as preoperative risk determinates. The three parameters combined together show high specificity and PPV for preoperative risk stratification and the risk stratification has not been detrimental with respect to oncological outcomes of recurrence.

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Section: Discussionsupporting

confidence: 83%

Early oncological outcomes and accuracy of risk stratification and tailoring surgical staging based on preoperative histology, Ca125 and MRI in endometrial cancer: a prospective cohort study

Mathews

Abraham

2019

Int J Reprod Contracept Obstet Gynecol

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“…9 The authors suugested that premenopausal patients without MRI evidence of deep myometrial invasion could be offered less extensive surgery. Duncan KA et al in their national audit of MRI accuracy in staging of endometrial cancer found concordance between MRI and reference standard of histopathology in 82% for myometrial invasion, 90% for cervical and 94% for pelvic nodal involvement.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of MR Imaging in endometrial cancer: our experience

Sampath

Nema

Agarwal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: MRI is a useful modality for preoperative imaging in endometrial cancer. We report our experience in Indian population managed at a tertiary care center regarding accuracy of preoperative MRI in prediction of deep myometrial invasion and cervical stromal invasion.Methods: 30 patients with endometrioid adenocarcinoma endometrium on endometrial biopsy underwent preoperative MRI in the week preceding surgery. MRI impression of depth of myometrial invasion, cervical stroma involvement and positive nodes were compared with final histopathology findings to calculate the accuracy of MRI.Results: The accuracy of MRI for estimation of tumour size was 72% and for detection of myometrial invasion was 76%. The accuracy for detection of cervical, adnexal and nodal involvement was 96%, 100% and 96% respectively.Conclusions: MRI is an accurate modality for preoperative assessment in endometrial cancer and can significantly assist in surgical planning.

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“…EC enhances less than normal myometrium after administration of intravenous gadolinium. [ 30 ] Dynamic contrast-enhanced MRI has a pooled sensitivity and specificity of 81% and 72%, respectively,[ 31 ] and T2-weighted imaging has a pooled sensitivity and specificity of 87% and 58%, respectively, in the assessment of myometrial invasion. [ 31 ] Dynamic contrast-enhanced images and T2WI together have an accuracy of 98% for assessing myometrial invasion.…”

Section: Introductionmentioning

confidence: 99%

Imaging in endometrial carcinoma

Faria

Sagebiel

Balachandran

et al. 2015

Indian Journal of Radiology and Imaging

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Endometrial carcinoma (EC) is the most common gynecologic malignancy in the United States. Prognosis depends on patient age, histological grade, depth of myometrial invasion and/or cervical invasion, and the presence of lymph node metastases. Although EC is staged surgically according to the International Federation of Gynecology and Obstetrics (FIGO) system, preoperative imaging can assist in optimal treatment planning. Several imaging techniques such as transvaginal ultrasonography (TVUS), computed tomography (CT), and magnetic resonance imaging (MRI) have been used as diagnostic tools for preoperative staging of EC. Recently, positron emission tomography (PET), PET/CT, and PET/MRI have also been used in staging these patients. In this article, we review the value of imaging in diagnosis, staging, treatment planning, and detection of recurrent disease in patients with EC.

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The accuracy of magnetic resonance imaging for preoperative deep myometrium assessment in endometrial cancer

Cited by 17 publications

References 16 publications

Early oncological outcomes and accuracy of risk stratification and tailoring surgical staging based on preoperative histology, Ca125 and MRI in endometrial cancer: a prospective cohort study

Early oncological outcomes and accuracy of risk stratification and tailoring surgical staging based on preoperative histology, Ca125 and MRI in endometrial cancer: a prospective cohort study

Accuracy of MR Imaging in endometrial cancer: our experience

Imaging in endometrial carcinoma

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