Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and histopathologic evaluation

Abstract

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.

Assessment of Myometrial Invasion in Endometrial Cancer by Transvaginal Sonography, Doppler Ultrasonography, Magnetic Resonance Imaging and Frozen Section

“…Two recent studies that investigated the accuracies of MRI for estimation of deep myometrial invasion determined the diagnostic accuracies as 81% and 90%. 5,21 The diagnostic accuracy of MRI (85%) in the present study was in accordance with literatures for prediction of deep myometrial invasion. Yamashita et al 9 have reported that MRI findings are incorrect usually in patients with adenomyosis, an intramural or subendometrial myoma, a polypoid tumor, a thin atrophic myometrium, or an atrophic junctional zone between the endometrium and the myometrium.…”

Magnetic resonance imaging to identify risk of lymph node metastasis in patients with endometrial cancer

“…For diagnosis of cervical invasion, sensitivity and specificity of MRI range from 50% to 72% and from 90% to 100%, respectively [9][10][11]. The diagnostic value of MRI for presurgical identification of patients at risk of lymph node metastasis, based on myometrial infiltration and cervical invasion of endometrial cancer, has not been reported.…”

Assessing Myometrial Infiltration by Endometrial Cancer: Uterine Virtual Navigation with Three-dimensional US

“…In many institutions, MR imaging has become a standard method. Sensitivity reported for this technique ranges from 80% to 91% (16)(17)(18)(19)(20)(21).…”

“…Contrast material-enhanced magnetic resonance (MR) imaging is considered the most reliable method and has an accuracy ranging from 62% to 95% (14)(15)(16)(17)(18)(19)(20). However, MR imaging is costly, has limited availability, and cannot be performed in all patients.…”