Normal uterus and FIGO stage I endometrial carcinoma: dynamic gadolinium-enhanced MR imaging.

Yamashita, Yasuyuki; Harada, Mikihiko; Sawada, Takamine; Takahashi, Manabu; Miyazaki, Kohji; Okamura, Hitoshi

doi:10.1148/radiology.186.2.8421757

Cited by 179 publications

(113 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: 92%

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: 92%

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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“…Nevertheless, there is no consensus in the literature regarding the added value of DCE-MRI in staging of endometrial cancer. Although the majority of the published studies demonstrate that the addition of multiphase DCE-MRI to T2W imaging leads to a significant improvement in the accuracy of assessment of the deep myometrial invasion [8,9,[11][12][13][14][15], some authors have found no significant difference [16,17].…”

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confidence: 99%

Advances in magnetic resonance imaging of endometrial cancer

Sala

Rockall

2010

Eur Radiol

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Endometrial cancer is the most commonly diagnosed gynaecological malignancy in affluent societies [1]. It occurs most frequently in white women, with peak incidence between ages 55 and 65. Risk factors include unopposed oestrogen intake, use of tamoxifen, nulliparity, obesity, and diabetes. The incidence of endometrial cancer in the United Kingdom has increased by more than 40% between 1993 and 2007. This significant rise is predominantly due to a large increase in incidence in women aged 60-79 [1]. These trends are very similar for most European countries [2]. The increase in prevalence of obesity and decreases in fertility may partly account for the observed rapid increase in incidence and imply that endometrial cancer in postmenopausal women will become a more substantial public health problem in the future.Prognosis depends on a number of factors, including stage, depth of myometrial invasion, lymphovascular invasion, nodal status and histological grade. Depth of myometrial invasion is the single most important morphologic prognostic factor, correlating with tumour grade, lymph node metastases and overall patient survival. Incidence of lymph node metastases increases from 3% with superficial myometrial invasion (stage IA) to 46% with deep myometrial invasion (stage IB) [3]. Preoperative knowledge of these factors is crucial in tailoring the surgical approach. The histological grade can be determined at endometrial sampling, whereas depth of myometrial invasion can only be assessed preoperatively by MRI. Therefore, MRI can assist in preoperative assessment and treatment planning by accurately predicting depth of myometrial invasion, cervical stromal invasion and lymph node involvement. This information allows selection of patients for pelvic or para-aortic lymph node sampling whilst obviating the need for surgery in patients with low risk disease. MRI can also provide additional useful information such as uterine size, tumour volume, ascites and adnexal pathology which in turn may determine whether the surgical approach is transabdominal, transvaginal or laparoscopic.Lymphadenectomy in early (stage I) endometrial cancer remains a controversial issue. Two large prospective multicentre studies investigated whether pelvic lymphadenectomy could improve survival of women with endometrial cancer [4,5]. Both studies reported no benefit in overall or recurrence free survival in the patients randomized to lymphadenectomy. Conversely, the SEPAL study [6] showed that in patients with intermediate or high risk of endometrial cancer recurrence, combined pelvic and paraaortic lymphadenectomy reduced the risk of death compared with pelvic lymphadenectomy alone. The authors acknowledged that MRI is an important factor for predicting lymph node metastasis, and in combination with tumour grade and histology could be helpful to discriminate patients with very low risk of recurrence. Therefore,

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Normal uterus and FIGO stage I endometrial carcinoma: dynamic gadolinium-enhanced MR imaging.

Cited by 179 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

Advances in magnetic resonance imaging of endometrial cancer

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