title: ACR Appropriateness Criteria® pretreatment evaluation and follow-up of endometrial cancer.
abstract: Endometrial cancer is the most common gynecologic and the fourth most common malignancy in women in the United States. Cross-sectional imaging plays a vital role in pretreatment assessment of endometrial cancers and should be viewed as a complementary tool for surgical evaluation and planning of these patients. Although transvaginal US remains the preferred examination for the screening purposes, MRI has emerged as the modality of choice for the staging of endometrial cancer and imaging assessment of recurrence or treatment response. A combination of dynamic contrast-enhanced and diffusion weighted MRI provides the highest accuracy for the staging. Both CT and MRI perform equivalently for assessing nodal involvement or distant metastasis. PET-CT is more appropriate for assessing lymphadenopathy in high-grade FDG-avid tumors or for clinically suspected recurrence after treatment. An appropriate use and guidelines of imaging techniques in diagnosis, staging, and detection of endometrial cancer and treatment of recurrent disease are reviewed.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: *University of Washington School of Medicine, Seattle, Washington; †Walter Reed National Military Medical Center, Bethesda, Maryland; ‡University of Utah Medical Center, Salt Lake City, Utah; §Sunnybrook Health Sciences Centre, Bayview Campus, Toronto, Ontario, Canada; ∥Henry Ford Health System, Detroit, Michigan; ¶Tufts Medical Center, Boston, Massachusetts, Society of Gynecologic Oncologists; #Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts; **Memorial Sloan Kettering Cancer Center, New York, New York; ††Mallinckrodt Institute of Radiology, St. Louis, Missouri, Society of Nuclear Medicine and Molecular Imaging; ‡‡Brigham & Women's Hospital, Boston, Massachusetts, American College of Obstetrics and Gynecology; §§Mallinckrodt Institute of Radiology, St. Louis, Missouri; ∥∥Columbia University, New York, New York, American College of Obstetrics and Gynecology; ¶¶University of Nebraska Medical Center, Omaha, Nebraska; ##University of Miami, Miami, Florida; and ***Valley Hospital, Ridgewood, New Jersey, American College of Obstetrics and Gynecology.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Lalwani
authors.forename: Theodore
authors.initials: T
authors.lastname: Dubinsky
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Javitt
authors.forename: David K
authors.initials: DK
authors.lastname: Gaffney
authors.forename: Phyllis
authors.initials: P
authors.lastname: Glanc
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elshaikh
authors.forename: Young Bae
authors.initials: YB
authors.lastname: Kim
authors.forename: Larissa J
authors.initials: LJ
authors.lastname: Lee
authors.forename: Harpreet K
authors.initials: HK
authors.lastname: Pannu
authors.forename: Henry D
authors.initials: HD
authors.lastname: Royal
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Shipp
authors.forename: Cary Lynn
authors.initials: CL
authors.lastname: Siegel
authors.forename: Lynn
authors.initials: L
authors.lastname: Simpson
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Wahl
authors.forename: Aaron H
authors.initials: AH
authors.lastname: Wolfson
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Zelop
mesh_terms: D003952:Diagnostic Imaging / Q000592:standards*; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011379:Prognosis