Can dynamic contrast enhanced magnetic resonance imaging change treatment planning in endometrial carcinoma?

Purpose: To detect the diagnostic accuracy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the assessment of myometrium and cervix infiltration and lymph node (L.N) status in patients with endometrial carcinoma. Patients and methods: Forty patients with pathologically proven endometrial carcinoma underwent preoperative MRI assessment in the National Cancer Institute, Cairo University, Egypt over three years from 2009 to 2012. Every case had one stage for the T2 weighted images (T2 WIs) alone and another stage for the combined T2 and DCE images according to the revised international federation of gynecology and obstetrics (FIGO) classification. The pathological findings after surgery were the reference standard. Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of T2 WIs in detection of deep myometrial invasion were 80%, 72%, 70%, 84% and 79%, respectively and 87%, 90%, 85%, 92% and 87%, respectively for DCE-MRI. For cervical infiltration, T2 WIs showed 78.5%, 88%, 73%, 90.5% and 82.5%, respectively while DCE-MRI showed 92%, 97%, 92%, 97% and 95%, respectively. T2 WIs and DCE-MRI had 100% sensitivity and 85% specificity for the detection of L. N metastasis. Conclusion: DCE-MRI can accurately detect invasion of the myometrium and cervix in cases of endometrial carcinoma. (C) 2013 Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V.