Hammersmith Hospital Imaging Department, Imperial College NHS Healthcare Trust, Du Cane Road, London, W12 OHS, UK.
Imaging Department, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
Eur Radiol. 2018 Nov;28(11):4725-4734. doi: 10.1007/s00330-018-5465-4. Epub 2018 May 22.
To evaluate the staging accuracy of magnetic resonance imaging (MRI) for endometrial cancer in daily practice over a 3-year period at a tertiary referral centre receiving scans from a large number of hospitals with varying protocols. To compare these daily practice results to published data from single-centre studies.
After ethical approval, MRI staging records for 270 studies from nine network and three centre hospitals were retrospectively collected and compared with final operative histopathology. The International Federation of Gynaecology and Obstetrics (FIGO) stage, depth of invasion assessment and cervical stromal invasion were analysed and reasons for discrepancies reviewed.
MRI-based complete FIGO stage was fully concordant with histopathology in 65.6%. MRI accuracy for depth of myometrial invasion and cervical stromal invasion was 73.3% and 89.3% respectively. Our results did not match the high accuracy previously reported in studies based on single centres.
Published MRI staging accuracy from small single-centre studies were not replicated in a tertiary referral centre receiving scans with heterogeneous protocols over a 3-year period. These results highlight the challenges faced in daily practice and may reflect achievable and realistic MRI staging accuracies in large rapid throughput referral networks. Adherence to standardised high-quality protocols may help to improve future results.
• Three-year MRI-staging accuracy for endometrial cancer in a multicentre cancer network • Daily practice MRI-staging accuracy did not meet results of single-centre studies • Large scale cancer network MRI-staging accuracies should be further evaluated • Treatment recommendations should be based on achievable MRI-staging accuracies.
在一家三级转诊中心，评估在 3 年期间使用 MRI 对子宫内膜癌进行分期的准确性，该中心接收来自许多具有不同方案的医院的扫描。将这些日常实践结果与来自单中心研究的已发表数据进行比较。
获得伦理批准后，回顾性收集了来自 9 家网络医院和 3 家中心医院的 270 项研究的 MRI 分期记录，并与最终的手术病理结果进行比较。分析国际妇产科联合会（FIGO）分期、浸润深度评估和宫颈间质浸润，并审查差异的原因。
MRI 基于完整的 FIGO 分期与组织病理学完全一致的比例为 65.6%。MRI 对肌层浸润深度和宫颈间质浸润的准确性分别为 73.3%和 89.3%。我们的结果与之前基于单中心研究报告的高准确性不匹配。
在三级转诊中心，在 3 年期间接收具有异质方案的扫描，并未复制发表的小单中心研究中的 MRI 分期准确性。这些结果突出了日常实践中面临的挑战，可能反映了在大型快速转诊网络中实现的和现实的 MRI 分期准确性。遵循标准化的高质量方案可能有助于提高未来的结果。
• 多中心癌症网络中 3 年的 MRI 分期准确性• 日常实践中的 MRI 分期准确性未达到单中心研究的结果• 应进一步评估大型癌症网络的 MRI 分期准确性• 治疗建议应基于可实现的 MRI 分期准确性。
