Learning objectives
To demonstrate diagnostic strategy of endometrial carcinoma by using advanced MR techniques.
To describe the clinical and imaging features of type I and type II endometrial carcinomas.
Background
Estrogen dependent (type I) and non-estrogen dependent (type II) endometrial carcinomas show different clinical behaviors,
imaging manifestations,
and therapeutic outcomes.
We demonstrate characteristic MR manifestations by using advanced MR techniques: Diffusion-weighted imaging (DWI); 3D-dynamic contrast-enhanced (DCE)-MRI; MR Spectroscopy (MRS); high-resolution (HR)-MRI in differential diagnosis,
tumor staging,
and addressing therapeutic strategy.
Imaging findings OR Procedure details
General features:
-Most common invasive gynecologic malignancy
-May appear as polypoid endometrial mass,
or diffuse endometrial thickening with or without myometrial invasion
-Most common symptom is abnormal genital bleeding
Prognostic factors:
-Histologic tumor grade
-Staging (especially,
Depth of myometrial invasion)
-Lymph node involvement
Therapeutic approach:
-Primary surgical treatment
-From conservative,
minimally invasive therapy: hormonal therapy,
to aggressive,
multidisciplinary therapy depending on tumor stage,
and patient’s age
Classification:
Classified into two pathogenic groups: Type I and Type II,
which show different clinical behaviors,
imaging manifestations,
and...
Conclusion
Advanced MR techniques are useful for the diagnosis of endometrial carcinomas and for the adequate therapeutic approach: from conservative,
minimally invasive therapy to aggressive,
multidisciplinary therapy.
References
1) Takeuchi M,
et al.
Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging.
Eur Radiol 2005;15:2244-55.
2) Frei KA,
et al.
Staging endometrial cancer: role of magnetic resonance imaging.
J Magn Reson Imaging 2001;13:850-5.
3) Manfredi R,
et al.
Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning.
Radiology 2004;231:372-8.
4) Boronow RC,
et al.
Surgical staging in endometrial cancer: clinical-pathologic findings of a prospective study.
Obstet Gynecol 1984;63:825-32.
5) Scoutt LM,
et al....
Personal Information
Mayumi Takeuchi,
MD,
PhD
Associate professor
Department of Radiology
University of Tokushima
3-18-15,
Kuramoto-cho
Tokushima city,
Zip:7708503
JAPAN
tel: 81-88-633-9283
fax: 81-88-633-7468
e-mail:
[email protected]