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Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results?

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Abstract

Objectives

To evaluate the staging accuracy of magnetic resonance imaging (MRI) for endometrial cancer in daily practice over a 3-year period at a tertiary referral centre receiving scans from a large number of hospitals with varying protocols. To compare these daily practice results to published data from single-centre studies.

Methods

After ethical approval, MRI staging records for 270 studies from nine network and three centre hospitals were retrospectively collected and compared with final operative histopathology. The International Federation of Gynaecology and Obstetrics (FIGO) stage, depth of invasion assessment and cervical stromal invasion were analysed and reasons for discrepancies reviewed.

Results

MRI-based complete FIGO stage was fully concordant with histopathology in 65.6%. MRI accuracy for depth of myometrial invasion and cervical stromal invasion was 73.3% and 89.3% respectively. Our results did not match the high accuracy previously reported in studies based on single centres.

Conclusions

Published MRI staging accuracy from small single-centre studies were not replicated in a tertiary referral centre receiving scans with heterogeneous protocols over a 3-year period. These results highlight the challenges faced in daily practice and may reflect achievable and realistic MRI staging accuracies in large rapid throughput referral networks. Adherence to standardised high-quality protocols may help to improve future results.

Key Points

• Three-year MRI-staging accuracy for endometrial cancer in a multicentre cancer network

• Daily practice MRI-staging accuracy did not meet results of single-centre studies

• Large scale cancer network MRI-staging accuracies should be further evaluated

• Treatment recommendations should be based on achievable MRI-staging accuracies

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Abbreviations

DCE:

Dynamic contrast enhancement

DWI:

Diffusion weighted imaging

EC:

Endometrial carcinoma

FIGO:

International Federation of Gynaecology and Obstetrics

MDTM:

Multi-disciplinary team meeting

MRI:

Magnetic resonance imaging

T1W:

T1-weighted

T2W:

T2-weighted

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Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. N. D. Soneji & A. Rockall

    Present address: Imaging Department, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK

  2. A. Ferri

    Present address: Ospedale San Rocco, Sessa Aurunca, Caserta, Italy

Authors and Affiliations

  1. Hammersmith Hospital Imaging Department, Imperial College NHS Healthcare Trust, Du Cane Road, London, W12 OHS, UK

    N. D. Soneji, N. Bharwani, A. Ferri, V. Stewart & A. Rockall

Authors
  1. N. D. Soneji
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  2. N. Bharwani
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  3. A. Ferri
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  4. V. Stewart
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  5. A. Rockall
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Corresponding author

Correspondence to N. D. Soneji.

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Guarantor

The scientific guarantor of this publication is Prof Andrea Rockall.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• cross-sectional

• multicentre study

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Soneji, N.D., Bharwani, N., Ferri, A. et al. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results?. Eur Radiol 28, 4725–4734 (2018). https://doi.org/10.1007/s00330-018-5465-4

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  • DOI: https://doi.org/10.1007/s00330-018-5465-4

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