Purpose
Endometrial cancer(EC) is the fourth most common tumor affecting women in developed countries,
with an incidence which is steadily rising because of increasing longevity and escalating levels of obesity.
Its prognosis depends on many factors,
such as stage,
depth of myometrial invasion,
cervical stroma and lympho-vascular invasion,
nodes status and histological grade (1).
Therefore,
preoperative information about depth of myometrial invasion and histological grade is essential in the planning of surgical approach of these patients.
Magnetic Resonance Imaging (MRI) is a very useful technique in...
Methods and Materials
Between August 2012 and November 2012 12 patients affected by hystologically proved EC were enrolled in our prospective study.
MR examination was performed on a 1,5T scanner (Symphony,
Siemens) equipped with high-performing gradients (amplitude 30 mT/m),
with patient in supine position; before exam beginning,
20 mg of N-butile-scopolamine were injected i.v.
to reduce bowel movements artifacts.
Then we started with TSE T2-weighted sequences on multiple planes (FOV:220X220,
slice thickness:4mm,effective matrix:384x75,
FA:180°,
TR:4400,
TE:104 both for sagittal and coronal planes; slicethickness:3mm,
effective matrix:320x75,
FA:180°,
FOV:280x280,
TR:5452,...
Results
Among the 12 patients enrolled in our study,
two of them were excluded because the histolgical result was atypical hyperplasia,
which is not detectable on MR images.
Therefore,
10 women in post-menopausal age were included in our study,
with a mean age of 63 yrs (range 50-76).
All the patients underwent surgery: in cases hysteroannessectomy was performed,
in 9 cases hysteroanessectomy with pelvic and lomboaortic nodes dissection was performed; the histological subtypes were endometrioid adenocarcinoma in 8 paients (80%) and clear cell adenocarcinoma in 2...
Conclusion
MR imaging is very accurate in the assessment of endometrial cancer,
delineating its local extent and its involvement of myometrial thickness; our results show that DCE-MR is able to detect myometrial infiltration with a higher accuracy than does T2w sequences.
However,
in literature there is some controversy regarding the added value of DCE-MR in staging of EC; the majority of studies have shown a improvement in staging and diagnostic accuracy with DCE-MR (4,7),
owing to its better overall resolution,
related to motion attifacts which are...
References
1- Beedy P,
Moyle P,
Kataoka M,
et al.
Evaluation of depth of myometrial invasion and overall staging in endometrial cancer: comparison of diffusion-weighted and dynamic contrast-enhanced MR imaging.
Radiology 2011;262(2):530-537.
2- Sala E,
Bockall A,
Kubik Buch RA,.
Advances in magnetic resonance imaging of endometrial cancer.
Eur Radiol 2011;21(3):408-473.
3- Rechichi G,
Galimberti S,
Signorelli M,
et al.
Myometrial invasion in endometrial cancer: diagnostic performance of diffusion weighted MR imaging at 1.5T.
Eur Radiol 2010;20(3):754-762.
4- Sala E,
Crawford R,
Senior E,
et al....