Can Preoperative Staging of Endometrial Carcinoma with Magnetic Resonance Imaging Accurately Predict Surgical Staging?, KHALID SAMIR, REDA HEMIDA, EMAD FYALA, ANAS GAMAL, YOUSEF ABO EL-KHIR, MAGDA SHAWKY and MUSTAFA EL-ZAYAT
Abstract
Objective: To investigate the concordance between pre-operative staging with MRI and surgical staging of endometrial carcinoma.
Methods: A cross sectional study was carried out during the period from January, 2013 to January 2016 and included 58 consecutive patients with pathologically confirmed en-dometrial carcinoma. Pre-operative staging with MRI was performed and compared to results of surgical staging and final pathology diagnosis.
Results: The mean age of the study group was 59.22±10.17 years. Most of the patients (82.8%) were postmenopausal. The MRI staging was identical to surgical staging in 52 cases while there were understagings in 2 cases and overstaging in 4 cases. For prediction of depth of myometrial invasion; MRI had sensitivity of 96% and specificity of 90.91% with 88.89% PPV and 96.77% NPV and for prediction of cervical involve-ment, the sensitivity was 80% and the specificity was 100% with 100% PPV and 98.15% NPV. The MRI had 60% sensi-tivity, 98.11% specificity, 75% PPV and 96.3% NPV for prediction of LNs metastasis.
Conclusion: MRI had a high diagnostic accuracy in predicting depth of myometrial invasion and cervical invasion, but less accurate in predicting lymph node metastasis. It can be considered as a valuable imaging modality for pre-operative staging of patients with endometrial cancer.