Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma?
<i>Background and Objectives</i>: Endometrial carcinoma is one of the most common gynecological cancers, and benign lesions such as endometrial hyperplasia, polyps, adenomyosis and leiomyomas should be included in the differential diagnosis. Magnetic resonance imaging has an important ro...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/1648-9144/60/3/512 |
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| author | Ramona-Andreea Rizescu Iulia Alecsandra Sălcianu Alexandru Șerbănoiu Radu Tudor Ion Lucian Mihai Florescu Ioana-Andreea Gheonea Gheorghe Iana Ana Magdalena Bratu |
| author_facet | Ramona-Andreea Rizescu Iulia Alecsandra Sălcianu Alexandru Șerbănoiu Radu Tudor Ion Lucian Mihai Florescu Ioana-Andreea Gheonea Gheorghe Iana Ana Magdalena Bratu |
| author_sort | Ramona-Andreea Rizescu |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Endometrial carcinoma is one of the most common gynecological cancers, and benign lesions such as endometrial hyperplasia, polyps, adenomyosis and leiomyomas should be included in the differential diagnosis. Magnetic resonance imaging has an important role in evaluating endometrial cancer and assessing the depth of myometrial invasion, and it closely correlates with the prognosis of the patient. The purpose of this study is to evaluate the MRI semiology of the endometrial carcinomas that mimic benign lesions, the main factors that may affect the correct diagnosis and the feasibility of magnetic resonance imaging to evaluate the depth of the myometrial invasion of endometrial cancer. <i>Materials and Methods</i>: This is a retrospective analysis of 45 patients that underwent MRI examinations and the lesions were pathologically diagnosed as endometrial carcinoma after surgical resection. This study evaluated the staging accuracy of T2-weighted imaging, diffusion-weighted imaging (DWI), ADC mapping and T1-weighted imaging with fat saturation before and after gadolinium injection. <i>Results</i>: In 36 of the 45 cases, the MRI of the lesion showed the characteristics of endometrial cancer and the diagnosis was certain. Nine lesions (20%) were described as unequivocal and had unspecific MR appearance. In eight of the nine cases (89%), the histopathologic report revealed the presence of leiomyomas and two of these cases (22%) were also associated with adenomyosis. The cause of underestimation in these patients was coexisting lesions exhibiting heterogenous intensity and contrast enhancement, which made it difficult to detect the margins of the lesions. The depth of the myometrial invasion was underestimated in nine cases and overestimated in three cases. The staging accuracy with MRI was 74%. There was a significant correlation between MR imaging and histopathologic finding in the assessment of myometrial invasion (<i>p</i> < 0.001). Cervical extension was noted in eight cases (18%), but was missed on MR imaging in two patients and overstaged in none. Six of them were associated with myometrial invasion in more than 50% of the thickness. There was a significant correlation between MR imaging and histopathologic finding in the assessment of cervical extension (<i>p</i> < 0.001). <i>Conclusions</i>: Our data confirm the high accuracy of MRI in the diagnosis and local staging of endometrial carcinoma. The information provided by MRI has an important role in planning the treatment and the prognosis of the patients. |
| first_indexed | 2024-04-24T18:02:04Z |
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| language | English |
| last_indexed | 2024-04-24T18:02:04Z |
| publishDate | 2024-03-01 |
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| spelling | doaj.art-e111baab2ee148bfb5096ac121ef6a7c2024-03-27T13:53:53ZengMDPI AGMedicina1010-660X1648-91442024-03-0160351210.3390/medicina60030512Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma?Ramona-Andreea Rizescu0Iulia Alecsandra Sălcianu1Alexandru Șerbănoiu2Radu Tudor Ion3Lucian Mihai Florescu4Ioana-Andreea Gheonea5Gheorghe Iana6Ana Magdalena Bratu7Doctoral School of the University of Medicine and Pharmacy Craiova, 200349 Craiova, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Craiova, 200349 Craiova, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Craiova, 200349 Craiova, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, RomaniaDepartment of Radiology and Medical Imaging, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania<i>Background and Objectives</i>: Endometrial carcinoma is one of the most common gynecological cancers, and benign lesions such as endometrial hyperplasia, polyps, adenomyosis and leiomyomas should be included in the differential diagnosis. Magnetic resonance imaging has an important role in evaluating endometrial cancer and assessing the depth of myometrial invasion, and it closely correlates with the prognosis of the patient. The purpose of this study is to evaluate the MRI semiology of the endometrial carcinomas that mimic benign lesions, the main factors that may affect the correct diagnosis and the feasibility of magnetic resonance imaging to evaluate the depth of the myometrial invasion of endometrial cancer. <i>Materials and Methods</i>: This is a retrospective analysis of 45 patients that underwent MRI examinations and the lesions were pathologically diagnosed as endometrial carcinoma after surgical resection. This study evaluated the staging accuracy of T2-weighted imaging, diffusion-weighted imaging (DWI), ADC mapping and T1-weighted imaging with fat saturation before and after gadolinium injection. <i>Results</i>: In 36 of the 45 cases, the MRI of the lesion showed the characteristics of endometrial cancer and the diagnosis was certain. Nine lesions (20%) were described as unequivocal and had unspecific MR appearance. In eight of the nine cases (89%), the histopathologic report revealed the presence of leiomyomas and two of these cases (22%) were also associated with adenomyosis. The cause of underestimation in these patients was coexisting lesions exhibiting heterogenous intensity and contrast enhancement, which made it difficult to detect the margins of the lesions. The depth of the myometrial invasion was underestimated in nine cases and overestimated in three cases. The staging accuracy with MRI was 74%. There was a significant correlation between MR imaging and histopathologic finding in the assessment of myometrial invasion (<i>p</i> < 0.001). Cervical extension was noted in eight cases (18%), but was missed on MR imaging in two patients and overstaged in none. Six of them were associated with myometrial invasion in more than 50% of the thickness. There was a significant correlation between MR imaging and histopathologic finding in the assessment of cervical extension (<i>p</i> < 0.001). <i>Conclusions</i>: Our data confirm the high accuracy of MRI in the diagnosis and local staging of endometrial carcinoma. The information provided by MRI has an important role in planning the treatment and the prognosis of the patients.https://www.mdpi.com/1648-9144/60/3/512endometrial cancerendometroid adenocarcinomaFederation of Gynecology and Obstetrics stagingmagnetic resonance imaging staging |
| spellingShingle | Ramona-Andreea Rizescu Iulia Alecsandra Sălcianu Alexandru Șerbănoiu Radu Tudor Ion Lucian Mihai Florescu Ioana-Andreea Gheonea Gheorghe Iana Ana Magdalena Bratu Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? Medicina endometrial cancer endometroid adenocarcinoma Federation of Gynecology and Obstetrics staging magnetic resonance imaging staging |
| title | Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? |
| title_full | Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? |
| title_fullStr | Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? |
| title_full_unstemmed | Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? |
| title_short | Can MRI Accurately Diagnose and Stage Endometrial Adenocarcinoma? |
| title_sort | can mri accurately diagnose and stage endometrial adenocarcinoma |
| topic | endometrial cancer endometroid adenocarcinoma Federation of Gynecology and Obstetrics staging magnetic resonance imaging staging |
| url | https://www.mdpi.com/1648-9144/60/3/512 |
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