Magnetic resonance imaging in the preoperative staging of endometrial carcinoma.
OBJECTIVE
Magnetic resonance imaging (MRI) has emerged as an important imaging modality in the evaluation of the extension of endometrial carcinoma which is essential in planning treatment and predicting prognosis. This study aimed to assess the value of MRI in the preoperative staging of endometrial carcinoma.


METHODS
We included in this study 162 patients with a histological diagnosis of endometrial carcinoma who underwent MRI pelvic imaging and surgical staging. MRI images were compared with pathological findings to measure MRI's sensitivity, specificity, positive and negative predictive values and diagnostic accuracy in what concerns myometrial, cervical and lymph node invasion.


RESULTS
MRI differentiation of deep myometrial invasion from superficial disease agreed with pathological findings in 77% of cases, with a sensitivity of 83%, a specificity of 72% and a diagnostic accuracy of 77%. Concerning cervical invasion, MRI had a sensitivity, specificity and diagnostic accuracy of 42%, 92%, 81% respectively. In assessing lymph node invasion, MRI presented a sensitivity of just 17%, a specificity of 99% and a diagnostic accuracy of 89%.


CONCLUSIONS
Our study confirmed the high accuracy of MRI imaging in assessing myometrial and cervical invasion in endometrial carcinoma. When evaluating lymph node invasion, micrometastases are responsible for the low sensitivy of MRI.
Cabrita
S
S
Department of Gynecology, University Hospital of Coimbra, Portugal. sofiacba@sapo.pt
Rodrigues
H
H
Abreu
R
R
Martins
M
M
Teixeira
L
L
Marques
C
C
Mota
F
F
de Oliveira
C Freire
CF
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D009367:Neoplasm Staging / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity