Role of Imaging in the Routine Management of Endometrial Cancer

Overview

Journal Int J Gynaecol Obstet

Publisher Wiley

Specialty Gynecology & Obstetrics

Date 2018 Oct 12

PMID 30306593

Citations 30

Authors

Ming Yin Lin

Andrew Dobrotwir

Orla McNally

Nadeem R Abu-Rustum

Kailash Narayan

Affiliations

Soon will be listed here.

Abstract

Endometrial cancer is the most common gynecologic cancer in women today. It is surgically staged, and while surgery is the primary treatment modality, the identification of disease extent-in particular extrauterine spread-prior to surgery is important to optimize treatment decision making. Ultrasound and MRI are useful for evaluating the extent of local disease, while CT and PET are used for detecting lymph node or distant metastases. Diffusion-weighted MRI has also been used for detecting small metastatic deposits in lymph nodes and omentum. Extrauterine soft tissue involvement can be detected by ultrasound, CT, MRI, and PET. Recently, intraoperative visualization techniques, such as sentinel lymph node mapping, are increasingly used to avoid extensive surgical staging without compromising treatment. Imaging is also used for planning adjuvant treatment and detection of postoperative residual disease in high-risk patients, monitoring and detecting recurrent disease, and in post-treatment surveillance of asymptomatic patients with high risk of relapse.

Citing Articles

Management of Endometrial Cancer: A Comparative Review of Guidelines.

Kopatsaris S, Tsakiridis I, Kapetanios G, Zachomitros F, Michos G, Papanikolaou E Cancers (Basel). 2024; 16(21).

PMID: 39518023 PMC: 11545286. DOI: 10.3390/cancers16213582.

Role of Multiparametric MRI in the Preoperative Evaluation of Endometrial Carcinoma: A Cross-Sectional Study.

Pati S, Mondal K, Bodhey N, Bagde N, Gupta R, Shukla A Cureus. 2024; 16(7):e65058.

PMID: 39171058 PMC: 11335962. DOI: 10.7759/cureus.65058.

Landscape of Endometrial Cancer: Molecular Mechanisms, Biomarkers, and Target Therapy.

Bostan I, Mihaila M, Roman V, Radu N, Neagu M, Bostan M Cancers (Basel). 2024; 16(11).

PMID: 38893147 PMC: 11171255. DOI: 10.3390/cancers16112027.

Preliminary Experience with Virtual Monoenergetic Imaging and Iodine Mapping in the Primary Staging of Endometrial Cancer.

Sauer S, Huflage H, Christner S, Patzer T, Kiesel M, Quenzer A Cancers (Basel). 2024; 16(6).

PMID: 38539562 PMC: 10968725. DOI: 10.3390/cancers16061229.

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer.

Van Vynckt L, Tummers P, Denys H, Goker M, Hendrickx S, Naert E Cancers (Basel). 2024; 16(6).

PMID: 38539477 PMC: 10968934. DOI: 10.3390/cancers16061142.

References

Mariani A, Webb M, Keeney G, Haddock M, Calori G, Podratz K . Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary?. Am J Obstet Gynecol. 2000; 182(6):1506-19. DOI: 10.1067/mob.2000.107335. View

Dijkhuizen F, Mol B, Brolmann H, Heintz A . The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000; 89(8):1765-72. View

Narayan K, Hicks R, Jobling T, Bernshaw D, McKenzie A . A comparison of MRI and PET scanning in surgically staged loco-regionally advanced cervical cancer: potential impact on treatment. Int J Gynecol Cancer. 2001; 11(4):263-71. DOI: 10.1046/j.1525-1438.2001.011004263.x. View

Belhocine T, De Barsy C, Hustinx R . Usefulness of (18)F-FDG PET in the post-therapy surveillance of endometrial carcinoma. Eur J Nucl Med Mol Imaging. 2002; 29(9):1132-9. DOI: 10.1007/s00259-002-0878-2. 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

Sohaib S, Houghton S, Meroni R, Rockall A, Blake P, Reznek R . Recurrent endometrial cancer: patterns of recurrent disease and assessment of prognosis. Clin Radiol. 2006; 62(1):28-34. DOI: 10.1016/j.crad.2006.06.015. View

Traen K, Holund B, Mogensen O . Accuracy of preoperative tumor grade and intraoperative gross examination of myometrial invasion in patients with endometrial cancer. Acta Obstet Gynecol Scand. 2007; 86(6):739-41. DOI: 10.1080/00016340701322077. View

Chi D, Barakat R, Palayekar M, Levine D, Sonoda Y, Alektiar K . The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology. Int J Gynecol Cancer. 2008; 18(2):269-73. DOI: 10.1111/j.1525-1438.2007.00996.x. View

Sanjuan A, Escaramis G, Ayuso J, Martinez Roman S, Torne A, Ordi J . Role of magnetic resonance imaging and cause of pitfalls in detecting myometrial invasion and cervical involvement in endometrial cancer. Arch Gynecol Obstet. 2008; 278(6):535-9. DOI: 10.1007/s00404-008-0636-1. View

10.

Cabrita S, Rodrigues H, Abreu R, Martins M, Teixeira L, Marques C . Magnetic resonance imaging in the preoperative staging of endometrial carcinoma. Eur J Gynaecol Oncol. 2008; 29(2):135-7. View

11.

Lin G, Ho K, Wang J, Ng K, Wai Y, Chen Y . Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T. J Magn Reson Imaging. 2008; 28(1):128-35. DOI: 10.1002/jmri.21412. View

12.

Kitchener H, Swart A, Qian Q, Amos C, Parmar M . Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2008; 373(9658):125-36. PMC: 2646126. DOI: 10.1016/S0140-6736(08)61766-3. View

13.

Kitajima K, Murakami K, Yamasaki E, Kaji Y, Sugimura K . Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer. Eur Radiol. 2009; 19(6):1529-36. DOI: 10.1007/s00330-008-1271-8. View

14.

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

15.

Leone F, Timmerman D, Bourne T, Valentin L, Epstein E, Goldstein S . Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet Gynecol. 2009; 35(1):103-12. DOI: 10.1002/uog.7487. View

16.

Cade T, Quinn M, McNally O, Neesham D, Pyman J, Dobrotwir A . Predictive value of magnetic resonance imaging in assessing myometrial invasion in endometrial cancer: is radiological staging sufficient for planning conservative treatment?. Int J Gynecol Cancer. 2011; 20(7):1166-9. DOI: 10.1111/igc.0b013e3181e9509f. View

17.

Narayan K, Khaw P, Bernshaw D, Mileshkin L, Kondalsamy-Chennakesavan S . Prognostic significance of lymphovascular space invasion and nodal involvement in intermediate- and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy. Int J Gynecol Cancer. 2011; 22(2):260-6. DOI: 10.1097/IGC.0b013e318230c264. View

18.

Tinga D, Timmer P, Bouma J, Aalders J . Prognostic significance of single versus multiple lymph node metastases in cervical carcinoma stage IB. Gynecol Oncol. 1990; 39(2):175-80. DOI: 10.1016/0090-8258(90)90428-n. View

19.

Barlin J, Khoury-Collado F, Kim C, Leitao Jr M, Chi D, Sonoda Y . The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: beyond removal of blue nodes. Gynecol Oncol. 2012; 125(3):531-5. DOI: 10.1016/j.ygyno.2012.02.021. View

20.

Lewandowski G, Torrisi J, Potkul R, Holloway R, Popescu G, Whitfield G . Hysterectomy with extended surgical staging and radiotherapy versus hysterectomy alone and radiotherapy in stage I endometrial cancer: a comparison of complication rates. Gynecol Oncol. 1990; 36(3):401-4. DOI: 10.1016/0090-8258(90)90151-a. View