title: Magnetic Resonance Imaging for the Pre-Surgical Assessment of Endometrial Cancer: Results in a Routine Clinical Setting, Outside Dedicated Trials; a Cross-sectional Study.
abstract: OBJECTIVE
  To assess the efficacy of magnetic resonance imaging (MRI) in predicting the surgical stage of endometrial carcinoma as a diagnostic tool, in a routine clinical setting, and not just in dedicated pilot studies or trials.
  
  
  METHODS
  The stage prediction made on MRI, as stated in the Radiology report, was compared with the effective surgical stage registered in the Pathology report. The 2009 International Federation of Gynecology and Obstetrics (FIGO) staging was used.
  
  
  RESULTS
  MRI and surgical stage correlated significantly (p<0.0001, r=0.43). However, there was only full concordance between predicted and true stage in 47.2% (43/91) of cases. Conversely, 11% (10/91) of cases were overstaged by MRI, whereas 41.8% (38/91) were understaged. For type-I tumors, where the decision to perform lymphadenectomy or not is crucial, there was full concordance in 63.9% of cases. What is more important, neither understaging (eight cases), nor overstaging (five cases) by MRI would have resulted in modification of the global treatment schedule, and thus potentially of prognosis. However, five patients would have undergone unnecessary surgery. On the other hand, half of the patients would have been correctly spared extended surgery.
  
  
  CONCLUSIONS
  If restricted to type-I tumors, pre-surgical MRI appears useful under routine clinical conditions, and helps avoid unnecessary surgery in 50% of selected cases.
authors.affiliation: Radiology, University Hospital, Santander, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Arnaiz
authors.affiliation: Obstetrics & Gynecology, University Hospital, Santander, Spain.
authors.forename: Ana-Belen
authors.initials: AB
authors.lastname: Muñoz
authors.affiliation: Obstetrics & Gynecology, University Hospital, Santander, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Verna
authors.affiliation: Pathology Services, Marqués de Valdecilla, University Hospital, Santander, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Gonzalez-Rodilla
authors.affiliation: Faculty of Medicine, Valladolid University, Valladolid, Spain jose.schneider@uva.es.
authors.forename: Jose
authors.initials: J
authors.lastname: Schneider
mesh_terms: D003430:Cross-Sectional Studies; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D057234:Preoperative Period
keywords: Endometrium; carcinoma; magnetic resonance; staging