[Endometrial Carcinoma]

Overview

Journal Radiologe

Specialty Radiology

Date 2011 May 12

PMID 21559925

Authors

K Engelhard

Affiliations

Soon will be listed here.

Abstract

Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool.

References

Kitajima K, Murakami K, Yamasaki E, Domeki Y, Kaji Y, Morita S . Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent uterine cancer: comparison with PET and enhanced CT. Eur J Nucl Med Mol Imaging. 2008; 36(3):362-72. DOI: 10.1007/s00259-008-0956-1. View

Nalaboff K, Pellerito J . Imaging the endometrium: disease and normal variants. Radiographics. 2001; 21(6):1409-24. DOI: 10.1148/radiographics.21.6.g01nv211409. View

Inada Y, Matsuki M, Nakai G, Tatsugami F, Tanikake M, Narabayashi I . Body diffusion-weighted MR imaging of uterine endometrial cancer: is it helpful in the detection of cancer in nonenhanced MR imaging?. Eur J Radiol. 2008; 70(1):122-7. DOI: 10.1016/j.ejrad.2007.11.042. View

Kinkel K, Forstner R, Danza F, Oleaga L, Cunha T, Bergman A . Staging of endometrial cancer with MRI: guidelines of the European Society of Urogenital Imaging. Eur Radiol. 2009; 19(7):1565-74. DOI: 10.1007/s00330-009-1309-6. View

Koyama T, Tamai K, Togashi K . Staging of carcinoma of the uterine cervix and endometrium. Eur Radiol. 2007; 17(8):2009-19. DOI: 10.1007/s00330-006-0555-0. View

Akin O, Mironov S, Pandit-Taskar N, Hann L . Imaging of uterine cancer. Radiol Clin North Am. 2006; 45(1):167-82. DOI: 10.1016/j.rcl.2006.10.009. View

Chung H, Kang S, Cho J, Kim J, Park N, Song Y . Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol. 2006; 104(3):654-9. DOI: 10.1016/j.ygyno.2006.10.007. View

Hauth E, Antoch G, Ruehm S, Boing C, Kimmig R, Forsting M . [Value of pelvic MRI in the preoperative diagnosis of endometriosis]. Rofo. 2004; 176(9):1265-70. DOI: 10.1055/s-2004-813401. View

Nag S, Cardenes H, Chang S, Das I, Erickson B, Ibbott G . Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: report from Image-Guided Brachytherapy Working Group. Int J Radiat Oncol Biol Phys. 2004; 60(4):1160-72. DOI: 10.1016/j.ijrobp.2004.04.032. View

10.

Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun M . Cancer statistics, 2007. CA Cancer J Clin. 2007; 57(1):43-66. DOI: 10.3322/canjclin.57.1.43. View

11.

Barwick T, Rockall A, Barton D, Sohaib S . Imaging of endometrial adenocarcinoma. Clin Radiol. 2006; 61(7):545-55. DOI: 10.1016/j.crad.2006.03.011. View

12.

Rechichi G, Galimberti S, Signorelli M, Perego P, Valsecchi M, Sironi S . Myometrial invasion in endometrial cancer: diagnostic performance of diffusion-weighted MR imaging at 1.5-T. Eur Radiol. 2009; 20(3):754-62. DOI: 10.1007/s00330-009-1597-x. View

13.

Takeuchi M, Matsuzaki K, Uehara H, Yoshida S, Nishitani H, Shimazu H . Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol. 2005; 15(11):2244-55. DOI: 10.1007/s00330-005-2814-x. View

14.

Lin G, Ng K, Chang C, Wang J, Ho K, Yen T . Myometrial invasion in endometrial cancer: diagnostic accuracy of diffusion-weighted 3.0-T MR imaging--initial experience. Radiology. 2009; 250(3):784-92. DOI: 10.1148/radiol.2503080874. View

15.

Manfredi R, Mirk P, Maresca G, Margariti P, Testa A, Zannoni G . Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology. 2004; 231(2):372-8. DOI: 10.1148/radiol.2312021184. View

16.

Pawinski A, Tumolo S, Hoesel G, Cervantes A, Van Oosterom A, Boes G . Cyclophosphamide or ifosfamide in patients with advanced and/or recurrent endometrial carcinoma: a randomized phase II study of the EORTC Gynecological Cancer Cooperative Group. Eur J Obstet Gynecol Reprod Biol. 1999; 86(2):179-83. DOI: 10.1016/s0301-2115(99)00066-4. View

17.

Frei K, Kinkel K, Bonel H, Lu Y, Zaloudek C, Hricak H . Prediction of deep myometrial invasion in patients with endometrial cancer: clinical utility of contrast-enhanced MR imaging-a meta-analysis and Bayesian analysis. Radiology. 2000; 216(2):444-9. DOI: 10.1148/radiology.216.2.r00au17444. View

18.

Nakao Y, Yokoyama M, Hara K, Koyamatsu Y, Yasunaga M, Araki Y . MR imaging in endometrial carcinoma as a diagnostic tool for the absence of myometrial invasion. Gynecol Oncol. 2006; 102(2):343-7. DOI: 10.1016/j.ygyno.2005.12.028. View

19.

Sanjuan A, Cobo T, Pahisa J, Escaramis G, Ordi J, Ayuso J . Preoperative and intraoperative assessment of myometrial invasion and histologic grade in endometrial cancer: role of magnetic resonance imaging and frozen section. Int J Gynecol Cancer. 2006; 16(1):385-90. DOI: 10.1111/j.1525-1438.2006.00414.x. View