EVALUATION OF MYOMETRIAL INVASION AND CERVICAL INVOLVEMENT IN TYPE I ENDOMETRIAL CANCER USING DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING
Keywords:Diffusion-weighted magnetic resonance imaging, Endometrial cancer, Myometrial invasion, Cervical involvement
Objective: Surgical procedure and adjuvant treatment of type I endometrial cancer were affected by some variables assessed preoperatively. Diffusion-weighted magnetic resonance imaging (DWI) is a promising modality in evaluating myometrial invasion and cervical involvement, investigating the diagnostic values of DWI in assessing myometrial invasion and cervical involvement.
Methods: A cross-sectional study was conducted. This study involved all type I endometrial cancer patients in Dr. Cipto Mangunkusumo Hospital from April 2016 until April 2019. The depth of myometrial invasion and cervical involvement was examined using 1.5-T MR unit. The result was compared to the surgical pathologic findings as the reference standard.
Results: 34 types I endometrial cancer patients were enrolled in this study. The sensitivity of DWI in evaluating myometrial invasion and cervical involvement in type I endometrial cancer was 94.12% and 57.14%, while the specificity was 64.71% and 92.59%, respectively.
Conclusion: DWI can provide reliable prognostic variable information about the myometrial invasion and cervical involvement in the preoperative preparation of endometrial cancer patients.
Bray F. Global cancer statistics globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin 2018;68:394-424.
Beddy P. Evaluation of the depth of myometrial invasion and overall staging in endometrial cancer: comparison of diffusion weightes and dynamic contrast-enhanced MR imaging. Radiology 2012;262:530-7.
Raglan O. Risk factors for endometrial cancer: an umbrella review of the literature. Int J Cancer 2019;145:1719-30.
McMillian N, Scavone J. Uterine neoplasms. NCCN Guidelines 2017;2:UN1-MS56.
Colombo N. ESMO-ESGO-ESTRO consensus conference on endometrial cancer. Int J Gynecol Cancer 2016;26:2-30.
Nougaret S. Endometrial cancer MRI staging: updated guidelines of the European society of urogenital radiology. Eur Radiol 2019;29:792-805.
Takeuchi M. Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion. Acta Radiol 2009;50:947.
Yan BC. The diagnostic performance of ADC value for tumor grade, deep myometrial invasion and lymphovascular space invasion in endometrial cancer: a meta-analysis. Acta Radiol 2019;1-10. DOI:10.1177/0284185119841988
Lin G. Endometrial cancer with cervical stromal invasion: diagnostic accuracy of diffusion-weighted and dynamic contrast-enhanced MR imaging at 3T. Eur Radiol 2017;27:1867-76.