Role of magnetic resonance imaging and cause of pitfalls in detecting myometrial invasion and cervical involvement in endometrial cancer.

OBJECTIVE

To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting myometrial invasion and cervical involvement in endometrial cancer.

STUDY DESIGN

Seventy two consecutive patients with endometrial carcinoma underwent preoperative MRI. We compared the MRI results with the final histopathological findings. We classify myometrial invasion as <50 or>or=50% and cervical involvement as positive or negative. Standard statistical calculations were used.

RESULTS

The sensitivity, specificity, and accuracy of MRI for the detection of myometrial invasion>or=50% were 71, 86, and 58%, respectively. Positive and negative predictive values are 77 and 83%, respectively. The sensitivity, specificity, and accuracy of MRI for the detection of cervical invasion were 41, 97, and 46%, respectively. Positive and negative predictive values are 71 and 89%, respectively. The possible causes of misdiagnosis included a tumor isointense with the myometrium, polypoid tumor, myometrial thinning, exceedingly irregular myometrium, presence of adenomiosis, and presence of leiomyomas.

CONCLUSION

MRI assists in planning the surgical treatment of endometrial cancer with an acceptable accuracy and a good specificity, although sensitivity is suboptimal.