title: MRI for local staging of endometrial carcinoma: Is endovenous contrast medium administration still needed?
abstract: OBJECTIVE
  To compare the diagnostic performance of T2-weighted images (T2-WI)+contrast-enhanced T1-weighted images (CE T1-WI) with the one of T2-WI+diffusion-weighted images (DWI) in the assessment of myometrial and cervical stromal infiltration by endometrial carcinoma (EC).
  
  
  METHODS
  Institutional review board approved our retrospective study; requirement for informed consent was waived. 56 patients with histologically proven EC who underwent preoperative MRI and surgery at our Institution over a 34 months period were included. Two radiologists independently evaluated T2-WI+CE T1-WI and T2-WI+DWI of each patient. Confidence in imaging evaluation (0-3), depth of myometrial invasion (</≥50%) and presence of cervical stromal infiltration (Yes/No) were assessed. MRI findings were compared with pathological ones.
  
  
  RESULTS
  Confidence in imaging evaluation was higher for T2-WI+CE T1-WI (2.83/3) than for T2-WI+DWI (2.62/3). T2-WI+DWI showed a better diagnostic performance than T2-WI+CE T1-WI in recognizing deep myometrial infiltration by EC (accuracy, sensitivity and specificity of 0.89, 0.89 and 0.89 vs. 0.86, 0.84, 0.86; p>0.05) whereas both imaging sequences combinations showed the same diagnostic performance in recognizing cervical stromal infiltration (accuracy, sensitivity and specificity of 0.95, 0.98 and 0.80, p>0.05).
  
  
  CONCLUSIONS
  T2-WI+DWI can reliably replace the "classical" combination T2-WI+CE T1-WI for local staging of endometrial carcinoma.
authors.affiliation: Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy. Electronic address: matteobonatti@hotmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonatti
authors.affiliation: Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Josef
authors.initials: J
authors.lastname: Stuefer
authors.affiliation: Department of Physics of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Oberhofer
authors.affiliation: Department of Pathology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Negri
authors.affiliation: Department of Gynecology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Tagliaferri
authors.affiliation: Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Günther
authors.initials: G
authors.lastname: Schifferle
authors.affiliation: Department of Gynecology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Messini
authors.affiliation: Department of Radiology of the University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.affiliation: Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.
authors.forename: Giampietro
authors.initials: G
authors.lastname: Bonatti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Endometrial cancer; Endometrial carcinoma; Endometrium; Pelvis; Staging; Uterus