Evaluation of Depth of Myometrial Invasion and Overall Staging in Endometrial Cancer: Comparison of Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging

Beddy, Peter; Moyle, Penelope; Kataoka, Masako; Yamamoto, Adam Kenji; Joubert, Ilse; Lomas, David J.; Crawford, Robin; Sala, Evis

doi:10.1148/radiol.11110984

Cited by 166 publications

(121 citation statements)

References 34 publications

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“…FLASH-3D is also able to detect signal foci or small lesions on T2WI, thus providing clearer information for the early diagnosis of muscular invasion, and cervical and lymph node metastases in patients with endometrial carcinoma. [11][12][13] Based on the detection of endometrial damage, junctional zone disruption and the extent of myometrial invasion, FLASH-3D can assess the degree of tumour infiltration and FIGO staging, which have great clinical significance.…”

Section: Discussionmentioning

confidence: 99%

“…0.05), in accord with previous reports. 4,10,13,16 The value of pre-operative staging focuses on early-stage (Stages I and II) disease. However, the accurate staging of early tumours is difficult because of the need to detect small lesions in the endometrium, given that tumours are only mildly enhanced by dynamic contrast during the early stage.…”

Section: Discussionmentioning

confidence: 99%

“…2,13,16 Enhanced MRI represents one of the most accurate methods for the pre-operative assessment of the depth of myometrial invasion. In patients with deep invasion of the myometrium, dynamic contrast-enhanced MRI significantly improves the signal-to-noise ratio for tumour and uterine wall muscle, allowing more accurate determination of the depth of myometrial invasion.…”

Section: Discussionmentioning

confidence: 99%

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Application of FLASH-3D dynamic contrast-enhanced imaging for diagnosis of endometrial carcinoma

Xiao-hu

Qiu

et al. 2016

BJR

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The authors Lixin Du and Xiaohu Li contributed equally to this article.Objective: To investigate the application and value of fast low-angle shot three-dimensional (FLASH-3D) dynamic contrast-enhanced MRI for the pre-operative staging of endometrial carcinoma. Methods: This prospective study enrolled 48 patients with complete clinical data and pathologically confirmed endometrial carcinoma from July 2012 to March 2014. After routine MRI examination, subjects underwent FLASH-3D dynamic contrast-enhanced examination. The dynamically enhanced features of the uterine wall and tumours were analyzed. FLASH-3D pre-operative staging and findings in relation to myometrial invasion were compared with post-operative pathological results in a double-blind manner. Results: There were 48 cases of pathologically proven endometrial carcinoma, including 34 patients with Stage I (Stage Ia 22 cases and Stage Ib 12 cases), 9 with Stage II, 3 with Stage III and 2 with Stage IV. The staging accuracy for endometrial carcinoma was 81% (39/48) using FLASH-3D dynamic contrast-enhanced sequences. The sensitivity, specificity and accuracy for the determination of deep myometrial invasion were 84%, 90% and 88%, respectively. There was no significant difference compared with the results of post-operative pathology (p . 0.05). Conclusion: FLASH-3D dynamic contrast-enhanced imaging may be valuable for the early diagnosis and preoperative staging of endometrial carcinoma. Its high accuracy for assessing deep myometrial invasion makes FLASH-3D imaging an important tool for selecting the optimal therapeutic protocol and for prognosis estimation. Advances in knowledge: FLASH-3D can significantly improve the accurate assessment of the depth of tumour invasion into the myometrium and may thus help to guide clinical surgical choices and post-operative evaluation. FLASH-3D is thus a promising technique for the routine examination of female pelvic tumours.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Application of FLASH-3D dynamic contrast-enhanced imaging for diagnosis of endometrial carcinoma

Xiao-hu

Qiu

et al. 2016

BJR

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“…Intracavitary brachytherapy with specialized intracavitary applicators is designed to deliver a high-dose boost to the involved uterine cavity; and further targeted radiation may be delivered to other areas of involvement, requiring image-guided dose delivery. Imaging plays an important role in these patients, including (a) CT for staging of tumor extent and target delineation for external beam radiation therapy; (b) MR imaging for assessment of tumor extent within the uterine cavity, particularly diffusion-weighted MR imaging (40), and response monitoring; and (c) intraoperative US to guide insertion of brachytherapy applicators.…”

Section: Endometrial Cancermentioning

confidence: 99%

Imaging across the Life Span: Innovations in Imaging and Therapy for Gynecologic Cancer

Xu‐Welliver¹,

Yuh²,

Macura

et al. 2014

RadioGraphics

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The focus of this article is radiation therapy for gynecologic cancers, with emphasis on imaging-based treatment planning and delivery. For the various gynecologic cancers, radiation oncologists rely on essential clinical information to triage treatment options, and various imaging studies are performed for treatment planning and radiation therapy delivery. A practical approach is provided to help radiologists tailor their reports for the needs of their radiation oncology and gynecologic oncology colleagues, to optimize multidisciplinary care for patients with gynecologic cancer. Template radiology reports are proposed to address the specific information needs of oncologists at each phase-before, during, and after treatment. Fueled by the rapid progress in engineering and computer sciences during the past 2 decades, remarkable advances have been made in anatomic, functional, and molecular imaging and in radiation treatment planning and delivery in patients with gynecologic cancer. Radiation therapy has evolved from a nontargeted approach to a precisely targeted, highly conformal treatment modality, to further improve treatment outcomes and reduce morbidity. Highquality imaging has become essential for staging of the disease, delineation of tumor extent for treatment planning and delivery, and monitoring therapy response. Anatomic and functional imaging has also been shown to provide prognostic information that allows clinicians to tailor therapy on the basis of personalized patient information. This field is an area of active research, and future clinical trials are warranted to validate preliminary results in the field.

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“…7,8 Lymph nodes (pelvic and para-aortic) should be assessed intraoperatively and biopsy or removal of enlarged nodes should be done.…”

Section: Pretreatment Evaluationmentioning

confidence: 99%

Cancer Endometrium: An Update

Kumar¹,

Goel²

2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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Endometrial cancer is the most common gynecological cancer in developed countries and second most common in developing countries. Its incidence is increasing in postmenopausal women. Factors related to chronic estrogen exposure are associated with a higher incidence. Abnormal uterine bleeding is the cardinal symptom. All women with suspected endometrial cancer require transvaginal ultrasonography and most will undergo endometrial biopsy; more sophisticated radiological examinations are required for preoperative staging. The general approach for treatment of endometrial cancer is hysterectomy, bilateral salpingo-oophorectomy, abdominopelvic washings, lymph node evaluation and maximal surgical cytoreduction for those with advanced disease. Postoperative adjuvant therapy [vaginal brachytherapy, external beam radiation therapy (RT), chemotherapy] may be recommended depending on the estimated risk of recurrence. Individual patient characteristics and surgical as well as pathologic staging are the main factors that are used for postsurgical risk stratification, which in turn, directs the selection of adjuvant treatment.

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Evaluation of Depth of Myometrial Invasion and Overall Staging in Endometrial Cancer: Comparison of Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging

Abstract: DW MR imaging has superior diagnostic accuracy in the assessment of myometrial invasion and significantly higher staging accuracy compared with DCE MR imaging.

Cited by 166 publications

References 34 publications

Application of FLASH-3D dynamic contrast-enhanced imaging for diagnosis of endometrial carcinoma

Application of FLASH-3D dynamic contrast-enhanced imaging for diagnosis of endometrial carcinoma

Imaging across the Life Span: Innovations in Imaging and Therapy for Gynecologic Cancer

Cancer Endometrium: An Update

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