Predictive Value of Magnetic Resonance Imaging in Assessing Myometrial Invasion in Endometrial Cancer

ObjectivesThe objectives of this study were to investigate the accuracy of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion in the preoperative assessment of women with endometrial cancer and to quantify the impact of MRI as an adjunct to predicting patients requiring full surgical staging.MethodsThis was a diagnostic accuracy study of prospective cases in conjunction with STARD guidelines using collected data from a tumor board within a cancer network. Consecutive series of all endometrial cancers in Northern Ireland over a 21-month period was discussed at the Gynaecological Oncology Multidisciplinary Team/tumor board meeting. This study concerns 183 women who met all the inclusion criteria. Main outcome measure was the correlation between the depth of myometrial invasion suggested by preoperative MRI study and the subsequent histopathological findings following examination of the hysterectomy specimen. Secondary end point was how MRI changed management of women who required surgery to be performed at a central cancer center.ResultsFor the detection of outer-half myometrial invasion, overall sensitivity of MRI was 0.73 (95% confidence interval [CI], 0.59–0.83), and specificity was 0.83 (95% CI, 0.76–0.89). The positive predictive value was 0.63 (95% CI, 0.50–0.74), and negative predictive value was 0.89 (95% CI, 0.82–0.93). Positive likelihood ratio was 4.35 (95% CI, 2.87–6.61), and negative likelihood ratio was 0.33 (95% CI, 0.21–0.52). Magnetic resonance imaging improved the sensitivity and negative predictive value of endometrial biopsy alone in predicting women with endometrial cancer who require full surgical staging (0.73 vs 0.65 and 0.80 vs 0.78, respectively).ConclusionsPreoperative pelvic MRI is a moderately sensitive and specific method of identifying invasion to the outer half of myometrium in endometrial cancer. Addition of MRI to preoperative assessment leads to improved preoperative assessment, triage, and treatment.

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309 Role of three-dimensional transvaginal ultrasound and diffusion-weighted magnetic resonance imaging for assessment of myometrial invasion in patients with low-risk endometrial cancer

10.1136/ijgc-2020-esgo.67 ◽

2020 ◽

Author(s):

Núria Carreras Diéguez ◽

Isabel Matas ◽

Crístian de Guirior ◽

Meritxell Munmany ◽

Pere Fusté ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Endometrial Cancer ◽

Magnetic Resonance ◽

Transvaginal Ultrasound ◽

Three Dimensional ◽

Myometrial Invasion ◽

Resonance Imaging ◽

Weighted Magnetic Resonance Imaging ◽

And Diffusion

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EVALUATION OF MYOMETRIAL INVASION AND CERVICAL INVOLVEMENT IN TYPE I ENDOMETRIAL CANCER USING DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2020.v12s3.39452 ◽

2020 ◽

pp. 4-6

Author(s):

HARIYONO WINARTO ◽

BRIAN PRIMA ARTHA ◽

SAHAT B. MATONDANG ◽

TANTRI HELLYANTI ◽

ARIA KEKALIH

Keyword(s):

Magnetic Resonance Imaging ◽

Endometrial Cancer ◽

Magnetic Resonance ◽

Cancer Patients ◽

Myometrial Invasion ◽

Type I ◽

Resonance Imaging ◽

Diffusion Weighted ◽

Weighted Magnetic Resonance Imaging ◽

Cervical Involvement

Objective: Surgical procedure and adjuvant treatment of type I endometrial cancer were affected by some variables assessed preoperatively. Diffusion-weighted magnetic resonance imaging (DWI) is a promising modality in evaluating myometrial invasion and cervical involvement, investigating the diagnostic values of DWI in assessing myometrial invasion and cervical involvement. Methods: A cross-sectional study was conducted. This study involved all type I endometrial cancer patients in Dr. Cipto Mangunkusumo Hospital from April 2016 until April 2019. The depth of myometrial invasion and cervical involvement was examined using 1.5-T MR unit. The result was compared to the surgical pathologic findings as the reference standard. Results: 34 types I endometrial cancer patients were enrolled in this study. The sensitivity of DWI in evaluating myometrial invasion and cervical involvement in type I endometrial cancer was 94.12% and 57.14%, while the specificity was 64.71% and 92.59%, respectively. Conclusion: DWI can provide reliable prognostic variable information about the myometrial invasion and cervical involvement in the preoperative preparation of endometrial cancer patients.

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Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer

Radiology and Oncology ◽

10.2478/raon-2020-0064 ◽

2021 ◽

Vol 55 (1) ◽

pp. 35-41

Author(s):

Pluvio J. Coronado ◽

Javier de Santiago-López ◽

Javier de Santiago-García ◽

Ramiro Méndez ◽

Maria Fasero ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Endometrial Cancer ◽

Magnetic Resonance ◽

Auxiliary Information ◽

Myometrial Invasion ◽

Figo Stage ◽

Mri Imaging ◽

Resonance Imaging ◽

Deep Myometrial Invasion ◽

Grade 3

AbstractBackgroundThe aim of the study was to determine if the endometrial tumor volume (TV) measured by magnetic resonance imaging (MRI-TV) is associated with survival in endometrial cancer and lymph nodes metastases (LN+).Patients and methodsWe evaluated the MRI imaging and records of 341 women with endometrial cancer and preoperative MRI from 2008 to 2018. The MRI-TV was calculated using the ellipsoid formula measuring three perpendicular tumor diameters. Tumor myometrial invasion was also analyzed.ResultsHigher MRI-TV was associated with age ≥ 65y, non-endometrioid tumors, grade-3, deep-myometrial invasion, LN+ and advanced FIGO stage. There were 37 patients with LN+ (8.8%). Non-endometrioid tumors, deep-myometrial invasion, grade-3 and MRI-TV ≥ 10 cm3 were the factors associated with LN+. Using a receiver operating characteristic [ROC] curve, the MRI-TV cut-off for survival was 10 cm3 (area under curve [AUC] = 0.70; 95% CI: 0.61–0.73). 5 years disease-free (DFS) and overall survival (OS) was significantly lower in MRI-TV ≥ 10 cm3 (69.3% vs. 84.5%, and 75.4% vs. 96.1%, respectively). MRI-TV was considered an independent factor of DFS (HR: 2.20, 95% CI: 1.09–4.45, p = 0.029) and OS (HR: 3.88, 95% CI: 1.34–11.24, p = 0.012) in multivariate analysis.ConclusionsMRI-TV was associated with LN+, and MRI-TV ≥ 10 cm3 was an independent prognostic factor of lower DFS and OS. The MRI-TV can be auxiliary information to plan the surgery strategy and predict the adjuvant treatment in women with endometrial cancer.

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