Can Magnetic Resonance Imaging Predict Pathologic Findings for Endometrioid Endometrial Cancer?

Authors

Elizabeth L. Dickson Michelson, Oncology, Aurora West Allis Medical CenterFollow
Jessica J. F. Kram, Aurora UW Medical Group, Aurora Health Care; Center for Urban Population HealthFollow
Kayla Heslin, Aurora UW Medical Group, Aurora Health Care; Center for Urban Population Health; Aurora Research InstituteFollow
David Baugh, Radiology, Aurora St. Luke’s Medical CenterFollow
Vikram Bamra, Radiology, Aurora St. Luke’s Medical CenterFollow
Jiahao Hu, Radiology, Aurora St. Luke’s Medical CenterFollow
Abhishek Shukla, Pathology, Aurora St. Luke’s Medical CenterFollow
Scott A. Kamelle, Oncology, Aurora St. Luke’s Medical CenterFollow

Publication Date

4-27-2020

Keywords

magnetic resonance imaging, endometrioid endometrial cancer, tumor diameter, myometrial invasion

Abstract

This pilot study aimed to assess the feasibility of precisely measuring tumor diameter and myometrial invasion in patients with endometrioid endometrial cancer (EEC) using preoperative contrast-enhanced magnetic resonance imaging (MRI). Adult patients with confirmed diagnosis of complex hyperplasia with atypia or EEC were included. Three radiologists separately measured tumor diameter and myometrial invasion. Basic descriptive statistics were used to describe patient characteristics and to compare radiology- and pathology-measured tumor diameter and myometrial invasion. Using the pathology results for tumor diameter as the gold standard for comparison, at least 1 radiologist was able to predict largest tumor diameter within 5 mm for 41.7% of patients. Similarly, based on pathology results for myometrial invasion, at least 1 radiologist was able to predict myometrial invasion within 5% for 50% of patients. All radiologists were able to predict superficial (< 50%) or deep (≥ 50%) myometrial invasion for 75% of patients, with greater sensitivity, specificity, and accuracy for deep myometrial invasion. Given variation among radiologic measurements, it is difficult to recommend preoperative MRI as a basis for measuring tumor diameter and myometrial invasion. Even so, the ability to predict superficial versus deep myometrial invasion may benefit patients with EEC for whom surgery is not a viable option or for those seeking fertility-sparing treatment options.

Recommended Citation

Dickson Michelson EL, Kram JJ, Heslin K, Baugh D, Bamra V, Hu J, Shukla A, Kamelle SA. Can magnetic resonance imaging predict pathologic findings for endometrioid endometrial cancer? J Patient Cent Res Rev. 2020;7:206-12. doi: 10.17294/2330-0698.1720