Preoperative evaluation of myometrial invasion in endometrial carcinoma: diagnostic performance of 3T MRI.
Summary of "Preoperative evaluation of myometrial invasion in endometrial carcinoma: diagnostic performance of 3T MRI."
PURPOSE:
To evaluate the diagnostic accuracy of 3T MRI in preoperative staging of myometrial invasion.
METHODS:
Twenty-eight women with histological diagnosis of endometrial carcinoma were included in this prospective study. After T2-W SS-TSE and DWI, dynamic series of T1-W THRIVE images were obtained (0-180 s) followed by a T1-W THRIVE sequence in the late phase (5th min). For detection of deep myometrial infiltration: sensitivity, specificity, PPV, NPV, and accuracy were calculated on T2-W, postcontrast early arterial and late phase T1-W, and DWI. For the quantitative analysis of DWI, ADC values of the tumor were calculated and correlated with histologic grade. For the quantitative evaluation of dynamic series, SI-time curves were obtained and the maximum relative enhancement, wash-in rate, time-to-peak, and wash-out rate of masses and myometrium were compared.
RESULTS:
T2-W and early phase contrast-enhanced sequences obtained sensitivity 100 %, specificity 76 %, PPV 58 %, NPV 100 %, and accuracy 82 %; late-phase contrast-enhanced images obtained sensitivity 100 %, specificity 81 %, PPV 64 %, NPV 100 %, and accuracy 86 %; DWI obtained lower accuracy [sensitivity 71 %, specificity 62 %, PPV 38 %, NPV 87 %, and accuary 57 %] than T2-W and postcontrast images. The MRE of carcinomas were significantly lower than those of the myometrium. This analysis showed a significant improvement in tumor versus myometrium contrast during the late phase. On DWI, the mean ADC value of tumor was 1.02 ± 0.48 × 10(-3). There was no statistically significant correlation between tumor grades and ADCs.
CONCLUSIONS:
As the 3T MRI scanner allows high-resolution images, accurate assessment of myometrial infiltration can be done especially with postcontrast late phase images.
Affiliation
Department of Radiology, School of Medicine, University of Kocaeli, Kocaeli Uni. Tip Fak, Radyoloji AD, 41380, Umuttepe, Kocaeli, Turkey.
Journal Details
This article was published in the following journal.
Name: Abdominal imaging
ISSN: 1432-0509
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22722382
- DOI: http://dx.doi.org/10.1007/s00261-012-9915-1
Medical and Biotech [MESH] Definitions
Carcinoma, Endometrioid
An adenocarcinoma characterized by the presence of cells resembling the glandular cells of the ENDOMETRIUM. It is a common histological type of ovarian CARCINOMA and ENDOMETRIAL CARCINOMA. There is a high frequency of co-occurrence of this form of adenocarcinoma in both tissues.
Carcinoma In Situ
A lesion with cytological characteristics associated with invasive carcinoma but the tumor cells are confined to the epithelium of origin, without invasion of the basement membrane.
Self-evaluation Programs
Educational programs structured in such a manner that the participating professionals, physicians, or students develop an increased awareness of their performance, usually on the basis of self-evaluation questionnaires.
Carcinoma, Intraductal, Noninfiltrating
A noninvasive (noninfiltrating) carcinoma of the breast characterized by a proliferation of malignant epithelial cells confined to the mammary ducts or lobules, without light-microscopy evidence of invasion through the basement membrane into the surrounding stroma.
Endometrial Stromal Tumors
Neoplasms of the endometrial stroma that sometimes involve the MYOMETRIUM. These tumors contain cells that may closely or remotely resemble the normal stromal cells. Endometrial stromal neoplasms are divided into three categories: (1) benign stromal nodules; (2) low-grade stromal sarcoma, or endolymphatic stromal myosis; and (3) malignant endometrial stromal sarcoma (SARCOMA, ENDOMETRIAL STROMAL).
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