Endometrial Cancer MRI staging: Updated Guidelines of the European Society of Urogenital Radiology

Nougaret, Stéphanie; Horta, Mariana; Sala, Evis; Lakhman, Yulia; Thomassin‐Naggara, Isabelle; Kido, Aki; Masselli, Gabriele; Bharwani, Nishat; Sadowski, Elizabeth A.; Ertmer, Andrea; Otero-García, Milagros; Ra, Kubik-Huch; Cunha, Teresa Margarida; Rockall, Andrea; Forstner, Rosemarie

doi:10.1007/s00330-018-5515-y

Cited by 208 publications

(218 citation statements)

References 94 publications

Supporting

Mentioning

212

Contrasting

Unclassified

Order By: Relevance

“…Preoperative radiological examination has been used to assess endometrial cancer, and magnetic resonance imaging (MRI) is the recommended diagnostic imaging method [8]. The updated guidelines of European Society of Urogenital Radiology recommend MRI as the imaging modality of choice for the evaluation of disease extent in patients with newly diagnosed endometrial cancer [9]. The European Society for Medical Oncology (ESMO), European Society for Radiotherapy & Oncology (ESTRO), and European Society of Gynaecological Oncology (ESGO) recommend preoperative MRI for the evaluation of myometrial invasion in patients with stage 1 endometrial cancer [2].…”

Section: Introductionmentioning

confidence: 99%

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

et al. 2019

View full text Add to dashboard Cite

Objectives:To examine the performance of preoperative magnetic resonance imaging (MRI) and intraoperative frozen sectioning in the assessment of myometrial invasion during the early stages of endometrial cancer. Material and methods:This retrospective study employed data from patients with endometrial cancer who were operated on between January 2013 and November 2018. Patients who underwent preoperative MRI and were of FIGO 2009 stage I were included in the study. Radiological staging and intraoperative staging by frozen sectioning were carried out. The data were analyzed to assess agreement of the overall results concerning myometrial invasion. Results:In total, 222 patients were enrolled. Their mean age was 58.3 ± 8.5 years. The accuracy of MRI for the detection of myometrial invasion was 88.7% and its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.6%, 82.1%, 92.2%, and 80.9%, respectively, with a kappa coefficient of 0.734 (95% confidence interval [CI], 0.684-0.784; p < 0.001). The accuracy of intraoperative frozen sectioning was 94.4%, and its sensitivity, specificity, PPV, and NPV were 97.7%, 85.7%, 94.7%, and 93.4%, respectively, with a kappa coefficient of 0.856 (95% CI, 0.812-0.900; p < 0.001). No significant difference in accuracy was observed between MRI and frozen sectioning (p = 0.057). MRI and frozen sectioning were sensitive for the detection of myometrial invasion, according to receiver operating curve analyses (areas under the curve, 0.869 and 0.917, respectively; p < 0.001). Conclusions:The assessment of myometrial invasion by preoperative MRI and intraoperative frozen sectioning during the early stages of endometrial carcinoma was highly accurate.

show abstract

Section: Introductionmentioning

confidence: 99%

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

et al. 2019

View full text Add to dashboard Cite

show abstract

“…T2WI is a conventional MR pulse sequence and one of the best MRI protocols for staging in patients with endometrial carcinoma according to the Updated Guidelines of the European Society of Urogenital Radiology [56]. On T2WI, cervical invasion was defined as a mass within the endocervical canal and/or disruption of the normal cervical stroma [25].…”

Section: Discussionmentioning

confidence: 99%

“…On DCE-MRI, cervical invasion was defined as interruption of the enhancement of the normal cervical epithelium [16]. Moreover, delayed DCE-MRI (4-5 min after the injection) are optimal for the detection of cervical invasion [56]. Previous research reported that DCE-MRI improved the detection of cervical infiltration by endometrial carcinoma [11].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of MRI for detecting cervical invasion in patients with endometrial carcinoma: A meta-analysis

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Clinical management and the prognosis of endometrial cancer is closely related to cervical invasion. The diagnostic performance of MRI for detecting cervical invasion has not been comprehensively assessed. We aim to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative assessment of cervical invasion and to analyze the influence of different imaging protocols in patients with endometrial carcinoma.Methods: An extensive search of articles about MRI in assessing cervical invasion in patients with endometrial carcinoma was performed in PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials from January 2000 to July 2019. Two reviewers independently evaluated the methodological quality of each study by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Diagnostic accuracy results and additional useful information were extracted. Pooled estimation data was obtained by statistical analysis. Results: A total of 42 eligible studies were included in the meta-analysis. Significant evidence of heterogeneity was found for detecting cervical invasion (I2 = 74.1%, P = 0.00 for sensitivity and I2 = 56.2%, P = 0.00 for specificity). And the pooled sensitivity and specificity of MRI were 0.58 and 0.95 respectively. The use of higher field strength (3.0 T) demonstrated higher pooled sensitivity (0.74). Using diffusion-weighted imaging (DWI) alone presented higher pooled sensitivity (0.86) than using other sequences. Studies that used dynamic contrast-enhanced MRI (DCE-MRI) alone showed higher sensitivity (0.80) and specificity (0.96) than that used T2-weighted image (T2WI) alone.Conclusions: MRI shows high specificity for detecting cervical infiltration in endometrial carcinoma. Using DWI or a 3.0-T device may improve the pooled sensitivity. The use of DCE-MRI demonstrate higher pooled sensitivity and specificity than T2WI.

show abstract

“…Appropriate preparation is important since this anatomic plane is difficult to assess in patients with an overdistended bladder. The presence of bladder mucosa edema does not indicate mucosal involvement [28][29][30][31].…”

Section: Bladder Adhesion or Invasionmentioning

confidence: 99%

Epithelial ovarian cancer: a review of preoperative imaging features indicating suboptimal surgery

2020

View full text Add to dashboard Cite

Epithelial ovarian cancer has been traditionally treated with cytoreductive surgery and chemotherapy. Optimal surgery is the key to improving the prognosis, and, thus, preoperative imaging should be carefully assessed to determine if the involvement of gastrointestinal, vascular, or thoracic surgeons is necessary to achieve this. Consequently, gynecologists should be able to recognize which imaging features suggest optimal or suboptimal resection. The aim of this review was to present the preoperative imaging features indicating suboptimal resection of epithelial ovarian cancer.

show abstract

Endometrial Cancer MRI staging: Updated Guidelines of the European Society of Urogenital Radiology

Cited by 208 publications

References 94 publications

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

Diagnostic accuracy of MRI for detecting cervical invasion in patients with endometrial carcinoma: A meta-analysis

Epithelial ovarian cancer: a review of preoperative imaging features indicating suboptimal surgery

Contact Info

Product

Resources

About