Comparison of dynamic contrast-enhanced magnetic resonance imaging with T2-weighted imaging for preoperative staging of early endometrial carcinoma. 2015

Linfeng Zheng, and Sujuan Zheng, and Xiaochun Yuan, and Xifu Wang, and Zhuoli Zhang, and Guixiang Zhang
Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China ; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

OBJECTIVE This study aimed to compare dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with T2-weighted imaging (T2WI) for the preoperative staging of early endometrial carcinoma. METHODS This retrospective study included 22 subjects with early endometrial carcinoma who underwent 3.0 T MRI examination prior to hysterectomy. DCE-MRI and T2WI were evaluated for the preoperative staging of endometrial carcinoma. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DCE-MRI and T2WI were assessed and compared using the revised International Federation of Gynecology and Obstetrics surgical staging guidelines (2009) as the reference standard. RESULTS Out of the 22 cases of endometrial carcinoma, the use of the reference standard method led to the staging of 14 as IA and eight as IB. The sensitivity, specificity, PPV, NPV, and accuracy of DCE-MRI for preoperative staging were 100% (95% confidence interval: 0.73-1.0), 62.5% (95% CI: 0.26-0.90), 82.4% (95% CI: 0.56-0.95), 100% (95% CI: 0.46-1.0), and 86.4%, respectively, and these values were 85.7% (95% CI: 0.56-0.97), 75% (95% CI: 0.36-0.96), 85.7% (95% CI: 0.56-0.97), 75% (95% CI: 0.36-0.96), and 81.8%, respectively, for T2WI. Thus, the sensitivity and accuracy of DCE-MRI were greater than those of T2WI for preoperative endometrial carcinoma staging. CONCLUSIONS DCE-MRI was more sensitive but less specific than T2WI for the preoperative staging of early endometrial carcinoma. DCE-MRI may serve as a useful and reliable tool for the preoperative assessment of endometrial carcinoma.

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