Endometrial Cancer MRI staging: Updated Guidelines of the European Society of Urogenital Radiology
To update the 2009 ESUR endometrial cancer guidelines and propose strategies to standardize image acquisition, interpretation and reporting for endometrial cancer staging with MRI.
The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to 81 questions regarding the details of patient preparation, MR imaging protocol, image interpretation and reporting were collected, analysed and classified as “RECOMMENDED” versus “NOT RECOMMENDED” (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts).
Consensus regarding patient preparation, MR image acquisition, interpretation and reporting was determined using the RAND-UCLA Appropriateness Method. A tailored MR imaging protocol and a standardized report were recommended.
These consensus recommendations should be used as a guide for endometrial cancer staging with MRI.
• MRI is recommended for initial staging of endometrial cancer.
• MR imaging protocol should be tailored based on the risk of lymph node metastases.
• Myometrial invasion is best assessed using combined axial-oblique T2WI, DWI and contrast-enhanced imaging.
• The mnemonic “Clinical and MRI Critical TEAM” summarizes key elements of the standardized report.
KeywordsMagnetic resonance imaging Endometrial cancer Guideline Diffusion Uterus
Cervical stromal invasion
Dynamic contrast-enhanced MRI
European Society for Medical Oncology
European Society of Urogenital Radiology
Field of view (FOV) optimized and constrained undistorted single-shot DWI
Magnetic resonance imaging
RAND-UCLA Appropriateness Method
Sentinel lymph node
The committee would like to thank Mr Arnold Stipsits, ESUR secretary, for his help with co-ordination of the committee members. The authors would like to acknowledge the contribution of information specialist Dr. Martina Gosteli (Main library - Medicine Careum, University of Zurich) for her valuable assistance with the database searches. We would like to thank the following colleagues: Henrik Leonhardt, Celine Alt, Federico Collettini, Laure Fournier, Diomidis Botsikas, Gavin Stewart, Athina C. Tsili, Theresa Mokry, Riccardo Manfredi, Laura Bunesch Villalba, Sonya Snape, Hebert Alberto Vargas, Maryna Brochwicz-Lewinski, M. Weston, Suzan M. Goldman and Sara Belião for participating to the questionnaire on behalf of the ESUR women’s imaging group. Authors thank Joanne Chin M.F.A. for her editorial assistance with the manuscript.
Yulia Lakhman's contribution to this work was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.
Compliance with ethical standards
The scientific guarantor of this publication is Rosemarie Forstner
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.
Written informed consent was not required for this study because no patient data were used.
Institutional review board approval was not required because no patient data were used.
• multicentre study
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