PREOPERATIVE ASSESSMENT OF MYOMETRIAL INVASION IN LOW-RISK ENDOMETRIAL CANCER BY 3D ULTRASOUND AND DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING

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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Diagnostic Accuracy of Magnetic Resonance Imaging in Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182571490 ◽

2012 ◽

Vol 22 (6) ◽

pp. 1020-1025 ◽

Cited By ~ 11

Author(s):

Mark H. McComiskey ◽

W. Glenn McCluggage ◽

Arthur Grey ◽

Ian Harley ◽

Stephen Dobbs ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Endometrial Cancer ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Myometrial Invasion ◽

Preoperative Assessment ◽

Tumor Board ◽

Resonance Imaging ◽

Outer Half

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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Myometrial invasion and overall staging of endometrial carcinoma: assessment using fusion of T2-weighted magnetic resonance imaging and diffusion-weighted magnetic resonance imaging

OncoTargets and Therapy ◽

10.2147/ott.s145763 ◽

2017 ◽

Vol Volume 10 ◽

pp. 5937-5943 ◽

Cited By ~ 4

Author(s):

Yu Guo ◽

Ping Wang ◽

Penghui Wang ◽

Wei Gao ◽

Fenge Li ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Endometrial Carcinoma ◽

Myometrial Invasion ◽

Resonance Imaging ◽

Diffusion Weighted ◽

Weighted Magnetic Resonance Imaging ◽

And Diffusion

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Preoperative Assessment of Myometrial Invasion in Endometrial Cancer by 3D Ultrasound and Diffusion-Weighted Magnetic Resonance Imaging: A Comparative Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000724 ◽

2016 ◽

Vol 26 (6) ◽

pp. 1105-1110 ◽

Cited By ~ 11

Author(s):

Adriano Rodríguez-Trujillo ◽

María José Martínez-Serrano ◽

Sergio Martínez-Román ◽

Cristina Martí ◽

Laura Buñesch ◽

...

Keyword(s):

Endometrial Cancer ◽

Early Stage ◽

Myometrial Invasion ◽

3D Ultrasound ◽

Resonance Imaging ◽

False Negatives ◽

Weighted Magnetic Resonance Imaging ◽

Sensitivity Specificity ◽

And Diffusion ◽

Early Stage Endometrial Cancer

ObjectiveThe prognosis of endometrial cancer depends on the correct surgical staging. In early stages, 18% to 30% rate of positive lymph nodes is reported with a myometrial invasion of 50% or more. According to this, patients with International Federation of Gynecology and Obstetrics stage Ib would benefit from staging lymphadenectomy. Therefore, it is important to classify these patients preoperatively to plan the surgery. In the recent years, 3-dimensional (3D) ultrasound and diffusion-weighted magnetic resonance imaging (DW-MRI) have been incorporated in the preoperative management of these patients. The aim of this study was to assess the usefulness of 3D ultrasound and DW-MRI as predictor of myometrial invasion in endometrial cancer.Material and MethodsWe retrospectively compared the assessment of myometrial invasion by 3D ultrasound and DW-MRI with final pathologic evaluation on hysterectomy specimens, in 98 patients diagnosed of early-stage endometrial cancer, who underwent surgery at the Hospital Clinic of Barcelona between 2012 and 2015.ResultsEvaluation of the depth of myometrial invasion with 3D ultrasound had a sensitivity, specificity, and accuracy of 77%, 83% and 81%, respectively. Evaluation of the depth of myometrial invasion with DW-MRI had a sensitivity, specificity, and accuracy of 69%, 86%, and 81%, respectively. Association of both techniques improved all the values, showing a sensitivity, specificity, and accuracy of 87%, 93%, and 91%, respectively. In both 3D ultrasound and DW-MRI, the presence of leiomyomas was the first detectable cause of false negative (3% and 4%, respectively) and false-positive (3% and 1%, respectively).ConclusionsWe conclude that the implementation of the 2 studies in early-stage endometrial cancer provides low false-negatives and false-positives rates. In cases of patients with leiomyomas, adenomiosis, or intrauterine fluid collection, definitive evaluation of myometrial invasion could be better deferred to intraoperative biopsy in an attempt to reduce false-negatives and false-positives rates.

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