title: MR assessment of myometrial invasion in women with endometrial cancer: discrepancy between T2-weighted imaging and contrast-enhanced T1-weighted imaging.
abstract: OBJECTIVE
  The purpose of the study was to investigate how frequently discrepant imaging findings are encountered between T2-weighted imaging and contrast-enhanced T1-weighted imaging in the preoperative magnetic resonance (MR) assessment of myometrial invasion in women with endometrial cancer.
  
  
  METHODS
  Seventy-one consecutive women (mean age, 59 years; age range 35-86 years) with endometrial cancer who underwent preoperative MR imaging were included in this single-institution, retrospective study. Depth of myometrial invasion was separately assessed on T2-weighted imaging and contrast-enhanced T1-weighted imaging, and the assessment was considered discrepant, when the two imaging sequences did not match each other. The image analysis also included potential pitfalls responsible for discrepant imaging findings, including the absence of the junctional zone, disruption of the junctional zone, extension to the uterine cornu, presence of leiomyoma and presence of adenomyosis. The results were correlated with histopathologic findings.
  
  
  RESULTS
  Of the 71 women, 19 (26.8%) showed discrepant imaging findings between T2-weighted imaging and contrast-enhanced T1-weighted imaging. Histopathologic findings revealed that contrast-enhanced T1-weighted imaging correctly depicted endometrial cancers in all women with discrepant MR imaging findings. Among the analyzed potential pitfalls, only disruption of the junctional zone showed a significant difference between women with concordant MR imaging findings (29.5%, 13/44) and women with discordant MR imaging findings (93.8%, 15/16) (p = 0.000).
  
  
  CONCLUSIONS
  In the preoperative MR assessment of myometrial invasion in women with endometrial cancer, discrepant imaging findings between T2-weighted imaging and contrast-enhanced T1-weighted imaging are frequently encountered, especially when the junctional zone is disrupted.
authors.affiliation: Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 41, Boramae-Gil, Dongjak-Gu, Seoul, 156-707, Korea. mmhoan@gmail.com.
authors.forename: Min Hoan
authors.initials: MH
authors.lastname: Moon
authors.affiliation: Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 41, Boramae-Gil, Dongjak-Gu, Seoul, 156-707, Korea.
authors.forename: Chang Kyu
authors.initials: CK
authors.lastname: Sung
authors.affiliation: Department of Pathology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
authors.forename: Yi Keong
authors.initials: YK
authors.lastname: Chun
authors.affiliation: Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Endometrial cancers; Gadolinium; MR; Staging