Radiology–pathology correlation of endometrial carcinoma assessment on magnetic resonance imaging

Dokter, Eveline; Anderson, Lyndal; Cho, Soo-Min; Cohen‐Hallaleh, Violette; Lam, Kim May; Saidi, Samir; Kitzing, Yu Xuan

doi:10.1186/s13244-022-01218-3

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…The retrospective review of these cases is an important improvement tool, and in four of the eight discordant cases, we could identify the presence of pitfalls such as cornual involvement, the presence of uterine leiomyomas, and metallic artifacts from prosthetic hip leading to under- or over-staging. These are known pitfalls in the staging of endometrial cancer, as is adenomyosis or atrophic myometrium [ 32 ]. In three cases, even despite the retrospective assessment of the MRI, no changes could safely be identified that would suggest the correct histologic stage.…”

Section: Discussionmentioning

confidence: 99%

Endometrial Cancer Staging: Is There Value in ADC?

Moreira

Ribeiro

Aringhieri

et al. 2023

JPM

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Purpose: To assess the ability of apparent diffusion coefficient (ADC) measurements in predicting the histological grade of endometrial cancer. A secondary goal was to assess the agreement between MRI and surgical staging as an accurate measurement. Methods: Patients with endometrial cancers diagnosed between 2018–2020 and having received both MRI and surgical staging were retrospectively enrolled. Patients were characterized according to histology, tumor size, FIGO stage (MRI and surgical stage), and functional MRI parameters (DCE and DWI/ADC). Statistical analysis was performed to determine if an association could be identified between ADC variables and histology grade. Secondarily, we assessed the degree of agreement between the MRI and surgical stages according to the FIGO classification. Results: The cohort included 45 women with endometrial cancer. Quantitative analysis of ADC variables did not find a statistically significant association with histological tumor grades. DCE showed higher sensitivity than DWI/ADC in the assessment of myometrial invasion (85.00% versus 65.00%) with the same specificity (80.00%). A good agreement between MRI and histopathology for the FIGO stage was found (kappa of 0.72, p < 0.01). Differences in staging between MRI and surgery were detected in eight cases, which could not be justified by the interval between MRI and surgery. Conclusions. ADC values were not useful for predicting endometrial cancer grade, despite the good agreement between MRI interpretation and histopathology of endometrial cancer staging at our center.

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Section: Discussionmentioning

confidence: 99%

Endometrial Cancer Staging: Is There Value in ADC?

Moreira

Ribeiro

Aringhieri

et al. 2023

JPM

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“…EC is divided into type I and type II. Type I is the most common and includes endometrioid adenocarcinoma accounting to 75-80% of all endometrial cancers according to literature data, while type II is more aggressive and shows a tendency to greater infiltration of the myometrium (8). The most common histological subtypes of type II are serous, clear-cell and undifferentiated EC.…”

Section: Introductionmentioning

confidence: 97%

“…It is considered that magnetic resonance imaging (MRI) can replace the limitations of the ultrasound examination in the assessment of the nature of endometrial lesions and that, its innovative techniques, the diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC), can increase the diagnostic accuracy in distinguishing between malignant and benign lesions of the endometrium (10). DWI is used to display tissue characteristics based on the Brownian diffusion motion of water molecules and is useful in assessing the extension and stage of the EC, detection of metastatic lymph nodes and the assessment of the response of the EC to therapy (8,11). ADC is joined to DWI and represents quantitative information about the diffusion of water molecules between tissue cells.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

et al. 2023

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IntroductionMagnetic resonance imaging (MRI) with its innovative techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), increases the diagnostic accuracy in distinguishing between malignant and benign lesions of the endometrium. The aim of the study was MRI differentiation between malignant and benign endometrial lesions and correlation with histopathological findings with a special emphasis on quantitative analysis. An additional aim was to correlate the ADC values and histological tumor grades.MethodsThe prospective study included 119 female patients with or without vaginal bleeding and pathological values of endometrial thickness, who underwent MRI examinations. According to MRI reports the patients were divided into 45 suspicious malignant and 74 suspicious benign endometrial lesions. The radiological diagnosis was compared to the histopathological evaluation, which confirmed 37 malignant lesions while the rest were benign.ResultsThe mean ADC value for malignant lesions was 0.761 ± 0.13×10−3 mm2/s and for benign lesions was 1.318 ± 0.20×10−3 mm2/s. The ADC values for malignant lesions were expectedly lower than those of benign lesions (p<0.001). The ADC cut-off value was 1.007×10−3 mm2/s with a sensitivity of 100%, specificity of 92.7%, a positive predictive value of 60.3%, and a negative predictive value of 100%. In comparison with the histopathological findings, the sensitivity of MRI was 100%, specificity 90.2%, positive predictive value was 82.2%, and negative predictive value was 100%. Observing the histological grades 1, 2, and 3 of endometrial carcinoma, no statistically significant differences of mean ADC values were found. The mean ADC values for histological tumor grades 1,2 and 3 were 0.803 ± 0.13×10−3 mm2/s, 0.754 ± 0.12×10−3 mm2/s and 0.728 ± 0.13×10−3 mm2/s, respectively.ConclusionDWI and ADC values represent clinically useful tools for the differentiation between malignant and benign endometrial lesions with high sensitivity and good specificity, but the results failed to demonstrate their usefulness in differentiating histological grades of endometrial cancer.

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Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

Kido,

Himoto,

Kurata

et al. 2023

Magnetic Resonance Imaging

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The staging of endometrial cancer is based on the International Federation of Gynecology and Obstetrics (FIGO) staging system according to the examination of surgical specimens, and has revised in 2023, 14 years after its last revision in 2009. Molecular and histological classification has incorporated to new FIGO system reflecting the biological behavior and prognosis of endometrial cancer. Nonetheless, the basic role of imaging modalities including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography, as a preoperative assessment of the tumor extension and also the evaluation points in CT and MRI imaging are not changed, other than several point of local tumor extension. In the field of radiology, it has also undergone remarkable advancement through the rapid progress of computational technology. The application of deep learning reconstruction techniques contributes the benefits of shorter acquisition time or higher quality. Radiomics, which extract various quantitative features from the images, is also expected to have the potential for the quantitative prediction of risk factors such as histological types and lymphovascular space invasion, which is newly included in the new FIGO system. This article reviews the preoperative imaging diagnosis in new FIGO system and recent advances in imaging analysis and their clinical contributions in endometrial cancer.Evidence Level4Technical EfficacyStage 3

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Radiology–pathology correlation of endometrial carcinoma assessment on magnetic resonance imaging

Cited by 8 publications

References 15 publications

Endometrial Cancer Staging: Is There Value in ADC?

Endometrial Cancer Staging: Is There Value in ADC?

Diagnostic value of the apparent diffusion coefficient in differentiating malignant from benign endometrial lesions

Preoperative Imaging Evaluation of Endometrial Cancer in FIGO 2023

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