Imaging in endometrial cancer.
The prognosis for women with endometrial cancer is generally good. This is because the disease is often diagnosed at an early treatable stage, as women seek care owing to postmenopausal bleeding. The prognosis is, however, worse for women with high-risk endometrial cancer. These women may benefit from more extensive surgery, including pelvic- and para-aortic lymph-node dissection, whereas such surgery is of no benefit for women with low-risk cancer. It is, therefore, important to correctly identify women with high-risk cancer before surgery. No consensus has been reached on how and when to use imaging to assess local extension of the disease. Nevertheless, evidence shows that imaging will improve the identification of women with high-risk cancer. The primary aim of this review is to present the examination technique, accuracy, imaging findings, benefits, and shortcomings of ultrasound and magnetic resonance imaging in the assessment of local tumour extension, in women with endometrial cancer. A secondary goal is to discuss the role of positron emission tomography and computed tomography, diagnostic modalities that primarily are used to detect lymph node and distant metastasis.
Department of Women's and Children's health, Karolinska University Hospital, 171 76 Stockholm, Sweden. Electronic address: elisabeth.epstein@karolinska.se.
Elisabeth
E
Epstein
Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden.
Lennart
L
Blomqvist
D016889:Endometrial Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014463:Ultrasonography
cervical invasion; endometrial cancer; imaging; magnetic resonance imaging; myometrial invasion; ultrasound