Document Detail


Evaluation of endometrial carcinoma on magnetic resonance imaging.
MedLine Citation:
PMID:  17291252     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our aims were to assess diagnostic performance of T2-weighted (T2W) and dynamic gadolinium-enhanced T1-weighted (T1W) magnetic resonance imaging (MRI) in the preoperative assessment of myometrial and cervical invasion by endometrial carcinoma and to identify imaging features that predict nodal metastases. Two radiologists retrospectively reviewed MR images of 96 patients with endometrial carcinoma. Tumor size, depth of myometrial and cervical invasion, and nodal enlargement were recorded and then correlated with histology. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) for the identification of any myometrial invasion (superficial or deep) were 0.94, 0.50, 0.93, 0.55 on T2W and 0.92, 0.50, 0.92, 0.50 on dynamic T1W, and for deep myometrial invasion were 0.84, 0.78, 0.65, 0.91 on T2W and 0.72, 0.88, 0.72, 0.88 on dynamic T1W. The sensitivity, specificity, PPV and NPV for any cervical invasion (endocervical or stromal) were 0.65, 0.87, 0.57, 0.90 on T2W and 0.50, 0.90, 0.46, 0.92 on dynamic T1W, and for cervical stromal involvement were 0.69, 0.95, 0.69, 0.95 on T2W and 0.50, 0.96, 0.57, 0.95 on dynamic T1W. Leiomyoma or adenomyosis were seen in 73% of misdiagnosed cases. Sensitivity and specificity for the detection of nodal metastases was 66% and 73%, respectively. Fifty percent of patients with cervical invasion on MRI had nodal metastases. In conclusion, MRI has a high sensitivity for detecting myometrial invasion and a high NPV for deep invasion. MRI has a high specificity and NPV for detecting cervical invasion. Dynamic enhancement did not improve diagnostic performance. MRI may allow accurate categorization of cases into low- or high-risk groups ensuring suitable extent of surgery and adjuvant therapy.
Authors:
A G Rockall; R Meroni; S A Sohaib; K Reynolds; F Alexander-Sefre; J H Shepherd; I Jacobs; R H Reznek
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  17     ISSN:  1048-891X     ISO Abbreviation:  Int. J. Gynecol. Cancer     Publication Date:    2007 Jan-Feb
Date Detail:
Created Date:  2007-02-12     Completed Date:  2007-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  188-96     Citation Subset:  IM    
Affiliation:
Department of Radiology, St Bartholomew's Hospital, West Smithfield, 59 Bartholomew Close, West Smithfield, London, United Kingdom. andrea.Rockall@bartsandthelondon.nhs.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Endometrial Neoplasms / pathology*
Female
Humans
Image Processing, Computer-Assisted
Lymph Nodes / pathology
Lymphatic Metastasis
Magnetic Resonance Imaging / methods*
Middle Aged
Neoplasm Invasiveness
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Liquid-based endometrial cytology: its possible value in postmenopausal asymptomatic women.
Next Document:  Paclitaxel and carboplatin in the treatment of advanced or recurrent endometrial cancer: a large ret...