Preoperative assessment of deep myometrial and cervical invasion in endometrial carcinoma: Comparison of magnetic resonance imaging and gross visual inspection

This study aimed to evaluate the accuracy of magnetic resonance imaging (MR I) in the detection of deep myometrial invasion and cervical extension by e ndometrial carcinoma. We also aimed to compare MRI results to surgical stag ing of endometrial carcinoma. Forty women with a histologic diagnosis of en dometrial carcinoma underwent a preoperative pelvic MRI. In 33 cases intrao perative gross visual inspection (GVI) of the surgical specimen was also ev aluated. The results obtained were compared with the histologic diagnosis. Pathologic evaluation of the myometrium determined that superficial invasio n was present in 25 patients and deep invasion in 15. The uterine cervix wa s found to be involved in 12 cases. The accuracy, sensitivity, and specific ity of MRI and GVI were 93%/91% 80%/77%, and 100%/100%, respectively, in de tecting deep myometrial invasion and 80%/79% 33%/36% and 100%/100%, respect ively, in determining cervical invasion. When the Kappa statistical measure ment was applied, the results from each technique, MRI and GVI, showed an a greement on the evaluation of myometrial and cervical invasion by endometri al carcinoma. In conclusion, rMRI, in this series, was demonstrated to be a reliable method for preoperative endometrial carcinoma "imagiological stag ing". The high accuracy achieved by MRI and GVI suggests that they may be u sed interchangeably.