title: Staging cancer of the uterus: a national audit of MRI accuracy.
abstract: OBJECTIVE
  To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread.
  
  
  METHODS
  All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively.
  
  
  RESULTS
  Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload.
  
  
  CONCLUSIONS
  Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.
authors.affiliation: Royal College of Radiologists, London, UK. k.duncan@nhs.net
authors.forename: K A
authors.initials: KA
authors.lastname: Duncan
authors.forename: K J
authors.initials: KJ
authors.lastname: Drinkwater
authors.forename: C
authors.initials: C
authors.lastname: Frost
authors.forename: D
authors.initials: D
authors.lastname: Remedios
authors.forename: S
authors.initials: S
authors.lastname: Barter
mesh_terms: D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008485:Medical Audit / Q000379:methods*; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D006113:United Kingdom; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014594:Uterine Neoplasms / Q000473:pathology*