Subendometrial enhancement and peritumoral enhancement for assessing endometrial cancer on dynamic contrast enhanced MR imaging

Fujii, Shinya; Kido, Aki; Baba, Tsukasa; Fujimoto, Koji; Daido, Sayaka; Matsumura, Noriomi; Konishi, Ikuo; Togashi, Kaori

doi:10.1016/j.ejrad.2015.01.004

Cited by 30 publications

(17 citation statements)

References 28 publications

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“…Diagnosis of myometrial invasion based on the disruption of SEE alone may result in increased rate of false positives. Presence of a thin irregular PTE correlates with both the presence and depth of myometrial invasion (59). Over and since the recent decade, DWI is increasingly employed as an assessment tool of the myometrial invasion.…”

Section: Endometrial Carcinomamentioning

confidence: 99%

Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Huang

et al. 2019

Korean J Radiol

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In this study, we summarize the clinical role of magnetic resonance imaging (MRI) in the diagnosis of patients with malignant uterine neoplasms, including leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, uterine carcinosarcoma, and endometrial cancer, with emphasis on the challenges and disadvantages. MRI plays an essential role in patients with uterine malignancy, for the purpose of tumor detection, primary staging, and treatment planning. MRI has advanced in scope beyond the visualization of the many aspects of anatomical structures, including diffusion-weighted imaging, dynamic contrast enhancement-MRI, and magnetic resonance spectroscopy. Emerging technologies coupled with the use of artificial intelligence in MRI are expected to lead to progressive improvement in case management of malignant uterine neoplasms.

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Section: Endometrial Carcinomamentioning

confidence: 99%

Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Huang

et al. 2019

Korean J Radiol

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“…Diagnostic clues that are useful to confirm endometrium-confined disease include uninterrupted low-SI band of JZ on T2WI and a continuous rim of sub-endometrial enhancement (SEE, thin layer of early enhancement of inner JZ) on DCE-MRI acquired within first minute of intravenous administration of contrast medium (100, 101, 107). If SEE is not present, the inner surface of the enhanced myometrium should be smooth and sharply demarcated (Figure 7) (101).…”

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

“…Third, some tumors enhance similar to the myometrium. Lastly, peri-tumoral enhancement (early irregular enhancement around the tumor) can disrupt SEE and falsely indicated myometrial invasion (107). These pitfalls may be avoided or diminished if T2WI, DWI, and DCE-MRI are interpreted in conjunction with each other (38, 107, 108, 110).…”

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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Historically, cancer treatment has emphasized measures for the “cure” regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of Magnetic Resonance Imaging (MRI) in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.

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“…In this context, the ESUR recommends DCE to assess the presence of intact subendometrial enhancement (1). Uninterrupted enhancement of the subendometrial zone has been observed to be best at approximately 35-40 s after contrast administration and requires very accurate timing to implement conventional DCE sequences (5). The high temporal resolution of fbVIBE could be beneficial for identification of such early stages of endometrial carcinoma and may enable more individualized treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In its current guidelines, the European Society of Urogenital Radiology (ESUR) recommends dynamic contrast-enhanced (DCE) MRI for the staging of endometrial carcinomas and for facilitating patient selection before fertility-sparing management in organ-confined endometrial carcinoma and early stage cervical carcinoma that qualifies for trachelectomy (1,2). Numerous studies have shown that multiphasic contrast-enhanced MRI has high diagnostic accuracy for detecting deep myometrial invasion (MI) of endometrial carcinoma, an important prognostic factor that potentially influences not only treatment decisions, but also prognosis (3)(4)(5). Moreover, infiltrations of the bladder and rectal wall in advanced tumor stages can be seen better on contrast-enhanced sequences than on noncontrast-enhanced acquisitions (6).…”

Section: Introductionmentioning

confidence: 99%

Morphological and functional assessment of the uterus: “one-stop shop imaging” using a compressed-sensing accelerated, free-breathing T1-VIBE sequence

et al. 2020

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Background The combination of motion-insensitive, high-temporal, and spatial resolution imaging with evaluation of quantitative perfusion has the potential to increase the diagnostic capabilities of magnetic resonance imaging (MRI) in the female pelvis. Purpose To compare a free-breathing compressed-sensing VIBE (fbVIBE) with flexible temporal resolution (range = 4.6–13.8 s) with breath-hold VIBE (bhVIBE) and to evaluate the potential value of quantifying uterine perfusion. Material and Methods A total of 70 datasets from 60 patients (bhVIBE: n = 30; fbVIBE: n = 40) were evaluated by two radiologists. Only temporally resolved reconstruction (fbVIBE) was performed on 30 of the fbVIBE datasets. For a subset (n = 10) of the fbVIBE acquisitions, a time- and motion-resolved reconstruction (mrVIBE) was evaluated. Image quality (IQ), artifacts, diagnostic confidence (DC), and delineation of uterine structures (DoS) were graded on Likert scales (IQ/DC/DoS: 1 (non-diagnostic) to 5 (perfect); artifacts: 1 (no artifacts) to 5 (severe artifacts)). A Tofts model was applied for perfusion analysis. Ktrans was obtained in the myometrium (Mm), junctional zone (Jz), and cervix (Cx). Results The median IQ/DoS/DC scores of fbVIBE (4/5/5 κ >0.7–0.9) and bhVIBE (4/4/4; κ = 0.5–0.7; P > 0.05) were high, but Artifacts were graded low (fbVIBE/bhVIBE: 2/2; κ = 0.6/0.5; P > 0.05). Artifacts were only slightly improved by the additional motion-resolved reconstruction (fbVIBE/mrVIBE: 2/1.5; P = 0.08); fbVIBE was preferred in most cases (7/10). Significant differences of Ktrans values were found between Cx, Jz, and Mm (0.12/0.21/0.19; P < 0.05). Conclusion The fbVIBE sequence allows functional and morphological assessment of the uterus at comparable IQ to bhVIBE.

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Subendometrial enhancement and peritumoral enhancement for assessing endometrial cancer on dynamic contrast enhanced MR imaging

Cited by 30 publications

References 28 publications

Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Morphological and functional assessment of the uterus: “one-stop shop imaging” using a compressed-sensing accelerated, free-breathing T1-VIBE sequence

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