title: Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies.
abstract: BACKGROUND
  To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer.
  
  
  METHODS
  Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to March 2012. Pooled estimation data were obtained by statistical analysis.
  
  
  RESULTS
  Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05).
  
  
  CONCLUSIONS
  CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. wlmssmu@gmail.com
authors.forename: Lian-Ming
authors.initials: LM
authors.lastname: Wu
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Xu
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Gu
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
authors.forename: Jiani
authors.initials: J
authors.lastname: Hu
mesh_terms: D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media