Assessing Myometrial Invasion by Endometrial Carcinoma with Dynamic MRI

Ito, Katsuyoshi; Matsumoto, Tsuneo; Nakada, Taishi; Nakanishi, Takashi; Fujita, Nobuyuki; Yamashita, Hiroyuki

doi:10.1097/00004728-199401000-00017

Cited by 79 publications

(45 citation statements)

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“…Our results are in keeping with previous series (Hardesty et al 2000;Yamashita et al 1993;Ito et al 1994). We obtained an accuracy of 95% in the evaluation of deep myometrial invasion and an accuracy of 88% regarding cervical extension.…”

Section: Discussionsupporting

confidence: 91%

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: Discussionsupporting

confidence: 91%

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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“…In the case of local extension, the reported rate of accurate diagnosis of myometrial invasion is 58 77 [21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

“…In particular, a contrast dynamic study is highly effective, improving accuracy signi cantly from 58 77 with T2-enhanced images alone to 85 93 [21][22][23][24] . However, despite this improvement, it is believed that allergies to contrast agents and the fact that contrast agents cannot be used in patients with compromised renal function will mean that, in the future, it will become more important to implement presurgical diagnosis of endometrial cancer using non-contrast MRI, along with diagnosing localized extension prior to surgery using basic MRI technology.…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Diffusion-weighted Imaging in Observing Localized Extension of Endometrial Cancer

Bell

Yagi

Hatano

et al. 2014

Showa Univ J Med Sci

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: Endometrial cancer is the seventh most common human malignancy and the most common form of cancer treated in women by obstetrics and gynecology departments. Until now, magnetic resonance imaging MRI has been used for pre-surgical evaluation of endometrial cancer and evaluating the depth of myometrial invasion, in addition to being a valuable diagnostic tool. Diffusion-weighted imaging DWI has been reported as useful in distinguishing between benign and malignant tumors when observing lesions in the endometrium. Subsequent reports suggest that DWI is also effective in identifying malignancy and diagnosing local extension in a range of tissues. Based on this, we implemented a study of the effectiveness of DWI in identifying local extension of endometrial cancer. This study enrolled patients undergoing surgery at this hospital for cancer of the uterine body during the six years from January 2008 to February 2014. Cases in which images were unclear or the lesions were too small to be described by MRI examination were excluded, leaving 61 patients in the study. Using the results from pre-surgical MRI, a sequence comprising a T2-weighted axial view alone and a T2-weighted axial view to which a diffusion-weighted axial view had been added was created for each patient. Two radiologists then independently examined the image sequence to determine localized extension. Following surgery, the presurgical assessment was compared to the localized extension determined by histopathology of post-surgical samples to evaluate the effectiveness of adding diffusionweighted imaging to the process. The rst radiographic interpreter s rate of correct diagnosis using the T2-weighted axial view alone was 45 out of 55 cases 81.8 , while using the T2-weighted axial view to which a diffusion-weighted axial view had been added gave a correct diagnosis rate of 51 out of 55 cases 92.7 . The second radiographic interpreter s rate of correct diagnosis using the T2-weighted axial view alone was 41 out of 55 cases 74.5 , while using the T2-weighted axial view with diffusion-weighted axial view added gave a correct diagnosis rate of 51 out of 55 cases 92.7 . These differences were statistically signi cant based on the McNemar testing. This study con rmed that DWI is an effective means of diagnosing localized extension from images. It is anticipated that DWI will be used in the future clinical workplace to provide more accurate pre-surgical diagnoses.

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“…The accuracy of T 2 -weighted images in the determination of myometrial invasion by endometrial carcinoma varies between 68 and 82% [30][31][32] . The use of a dynamic study after administration of intravenous contrast increases the accuracy of myometrial invasion to 85-91% [29,31,33] . The use of contrast-enhanced MRI in addition to the knowledge of tumor grade I is a good predictor for deep myometrial invasion.…”

Section: Staging Of Early Endometrial Carcinomamentioning

confidence: 99%

Fertility-Preserving Treatment in Young Women with Endometrial Cancer

Böing¹

2006

Gynäkol Geburtshilfliche Rundsch

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Nonsurgical fertility-preserving treatment of well-differentiated endometrial cancer with systemic progestins has been described for young women who desire to preserve their fertility. The overall response to progestin treatment in 9 retrospective studies is 79% with 79 subsequent live births. Recurrence can be expected in approximately 36–40% of conservatively treated patients who initially responded. Synchronous ovarian cancer has been reported in approximately 9%. However, amongst 162 receiving systemic, continuous treatment with progestins no death caused by cancer has been reported. We review guidelines for diagnosis, treatment and follow-up in young women undergoing conservative treatment for endometrial cancer.

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Assessing Myometrial Invasion by Endometrial Carcinoma with Dynamic MRI

Cited by 79 publications

References 0 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

The Usefulness of Diffusion-weighted Imaging in Observing Localized Extension of Endometrial Cancer

Fertility-Preserving Treatment in Young Women with Endometrial Cancer

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