Pathology & Oncology Research

, Volume 20, Issue 2, pp 327–333 | Cite as

Evaluation of the Accuracy of Preoperative MRI in Measuring Myometrial Infiltration in Endometrial Carcinoma

  • Katalin Horváth
  • Imre Pete
  • Ildikó Vereczkey
  • Anna Dudnyikova
  • Mária Gődény
Research

Abstract

The aim of our study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the pretreatment evaluation of myometrium invasion in endometrial cancer. Our retrospective study concerns 89 patients with endometrial cancer, who had preoperative MR evaluation of myometrium invasion and we compared it with histological results. Considering histological type and grade, we had excluded patients with poor prognosis, and separately evaluated those cases where the depth of myometrium invasion is the main prognostic factor determining the choice treatment. Of the 89 cases MRI had accurately evaluated the depth of myometrial invasion in 75 patients. Based on data from all cases, we found the sensitivity of detection of deep myometrial infiltration by MRI (Sv) 71 %, specificity (Sp) 92 %, accuracy (Acc) 84 %, positive predictive value (PPV) 86 % and negative predictive value (NPV) 83 %. Excluding patients with poor prognosis according to histology and grade, these data were Sv 71 %, Sp 95 %, Acc 87 %, PPV 90 %, NPV 84 %. In conclusion, MRI is an efficient diagnostic tool in assessing myometrial infiltration, which is necessary for proper preoperative staging and therapy planning, including evaluation of the necessity of lymphadenectomy. Certain factors may interfere with evaluation of MRI results, thus hindering the precise determination of the level of myometrial infiltration.

Keywords

MRI Endometrium carcinoma Myometrial infiltration Benign uterine lesions 

References

  1. 1.
    Bray F, Dos Santos Silva I, Moller H, Weiderpas E (2005) Endometrial cancer incidence trends in Europe: Underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev 14:1132–1142PubMedCrossRefGoogle Scholar
  2. 2.
  3. 3.
    Hungarian National Cancer Registry. http://www.oncol.hu/rakreg/stat2/nrr_2010.html
  4. 4.
    Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM et al (1998) Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 90:1371–1388PubMedCrossRefGoogle Scholar
  5. 5.
    Pecorelli S (2009) Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 105:103–104PubMedCrossRefGoogle Scholar
  6. 6.
    Sala E, Wakely S, Senior E, Lomas D (2007) MRI of Malignant Neoplasms of the Uterine Corpus and Cervix. Am J Roentgenol 188:1577–1587CrossRefGoogle Scholar
  7. 7.
    Lester SC (2010) Manual of surgical pathology, 3rd Edition, ElsevierGoogle Scholar
  8. 8.
    FIGO Committee on Gynecologic Oncology (2009) Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Int J Gynecol Obstet 105:103–104CrossRefGoogle Scholar
  9. 9.
    Harris M, Taylor G. Medical Statistics Made Easy, 2nd Edition 2008, Scion.Google Scholar
  10. 10.
    Levine DA, De Los Santos JF, Fleming GF, Barakat RR, Markman M, Randall ME (2010) Handbook for principles and practice of gynecologic oncology. Lippincott, Williams and WilkinsGoogle Scholar
  11. 11.
    Chen JK, Cheung MK, Huh WK, Osann K, Husain A, Teng NN, Kapp DS (2006) Therapeutic role of lymph node resection in endometrioid corpus cancer: a study of 12,333 patients. Cancer 107:1823–1830CrossRefGoogle Scholar
  12. 12.
    Kitchener H, Swart AM, Quian Q, Amos C, Parmar MK (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomized study. Lancet 373:125–136PubMedCrossRefGoogle Scholar
  13. 13.
    Balleyguier C, Sala E, Da Cuncha T, Bergman A, Brkljacic B, Danza F et al (2011) Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol 21:1102–1110PubMedCrossRefGoogle Scholar
  14. 14.
    Kinkel K, Forstner R, Danza FM, Oleaga L, Cunha TM, Bergman A et al (2009) Staging of endometrial cancer with MRI: guidelines of the European Society of Urogenital Imaging; European Society of Urogenital Imaging. Eur Radiol 19:1565–1574PubMedCrossRefGoogle Scholar
  15. 15.
    Rockall AG, Merony R, Sohaib SA, Reynolds K, Alexander-Sefre F, Shepherd JH, Jacobs I, Reznek EH (2007) Evaluation of endometrial carcinoma on magnetic resonance imaging. Int J Gynecol Cancer 17:188–196PubMedCrossRefGoogle Scholar
  16. 16.
    Chung HH, Kang SB, Cho JY, Kim JW, Park NH, Song YS, Kim SH, Lee HP (2007) Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol 104:654–659PubMedCrossRefGoogle Scholar
  17. 17.
    Rechichi G, Galimberti S, Signorelli M, Perego P, Valsecchi MG, Sironi S (2010) Myometrial invasion in endometrial cancer: diagnostic performance of diffusion-weighted MR imaging at 1,5-T. Eur Radiol 20:754–762PubMedCrossRefGoogle Scholar
  18. 18.
    Nakao Y, Yokoyama M, Hara K, Koyamatsu Y, Yasunaga M, Araki Y, Watanabe Y, Iwasaka T (2006) MR imaging in endometrial carcinoma as a diagnostic tool for the absence of myometrial invasion. Gynecol Oncol 102:343–347PubMedCrossRefGoogle Scholar
  19. 19.
    Ortashi O, Jain S, Emannuel O, Henry R, Wood A, Evans J (2008) Evaluation of the sensitivity, specificity, positive and negative predictive values of preoperative magnetic resonance imaging for staging endometrial cancer. A prospective study of 100 cases at the Dorset cancer centre. Eur J Obstet Gynecol Reprod Biol 137:232–235PubMedCrossRefGoogle Scholar
  20. 20.
    Hwang JH, Lee KW, Lee JK (2009) Magnetic resonance imaging for assessment of deep endometrial invasion for patients with endometrial carcinoma. Aust N Z J Obstet Gynaecol 49:537–541PubMedCrossRefGoogle Scholar
  21. 21.
    Emlik D, Ozdemir S, Celik C, Karaköse S (2010) Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma: comparison of multi-section dynamic MR imaging using a 3D FLASH technique and T2 weighted MR imaging. J Med Imag Radiat Oncol 54:202–210CrossRefGoogle Scholar
  22. 22.
    McComiskey MH, McCluggage WG, Grey A, Harley I, Dobbs S, Nagar HA (2012) Diagnostic accuracy of magnetic resonance imaging in endometrial cancer. Int J Gynecol Cancer 22:1020–1025PubMedCrossRefGoogle Scholar

Copyright information

© Arányi Lajos Foundation 2013

Authors and Affiliations

  • Katalin Horváth
    • 1
    • 2
  • Imre Pete
    • 3
  • Ildikó Vereczkey
    • 4
  • Anna Dudnyikova
    • 3
  • Mária Gődény
    • 1
    • 2
  1. 1.Department of Radiological DiagnosticsNational Institute of OncologyBudapestHungary
  2. 2.University of Medicine and Pharmacy of Târgu MureşTârgu MureşRomania
  3. 3.Department of GynecologyNational Institute of Oncology BudapestBudapestHungary
  4. 4.Surgical and Molecular Tumour Pathology CentreNational Institute of Oncology BudapestBudapestHungary

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