Reliability of magnetic resonance imaging in assessing myometrial invasion absence in endometrial carcinoma.
OBJECTIVE
This study evaluated the reliability of magnetic resonance imaging (MRI) in assessing the absence of myometrial invasion in endometrial carcinoma patients, to identify candidates for conservative hormonal treatment.


METHODS
A total of 301 endometrial carcinoma patients who showed Stage I findings on preoperative MRI, and had received staging operations were reviewed retrospectively. We compared MRI findings of myometrial invasion with myometrial invasion levels reported by pathologists when surgical specimens were examined.


METHODS
A descriptive study.


METHODS
Tertiary care gynecologic oncology clinic, Seoul, Korea.


METHODS
A total of 301 endometrial carcinoma patients who showed Stage I findings on preoperative MRI, and had received staging operations.


METHODS
We compared MRI findings of myometrial invasion with myometrial invasion levels reported by pathologists when surgical specimens were examined.


RESULTS
Of 301 patients, 17 showed higher stages (FIGO Stages IIA through IIIC) on the final pathology of surgical specimen. Among the 284 patients with Stage I on histology reports, 124 showed no myometrial invasion on preoperative MRI (FIGO Stage IA). The negative predictive value (probability of absence of myometrial invasion) was 49.2%. MRI showed an accuracy of 59.2%, a sensitivity of 68.8%, a specificity of 74.4%, and an 86.9% positive predictive value, for myometrial invasion.


CONCLUSIONS
MRI had a rather weak predictive value when used to assess absence of myometrial invasion. This should be borne in mind when choosing patients for conservative treatment of endometrial carcinoma.
Suh
Dae-Shik
DS
Department of Obstetrics and Gynecology, Asan Medical Center, Division of Gynecologic Oncology, College of Medicine, University of Ulsan, Seoul, Korea. dssuh@amc.seoul.kr
Kim
Jeong Kon
JK
Kim
Kyu Rae
KR
Kim
Dae-Yeon
DY
Kim
Jong-Hyeok
JH
Kim
Yong-Man
YM
Kim
Young-Tak
YT
Nam
Joo-Hyun
JH
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies