Purpose: To assess the MR imaging (MRI) in initial decision making of endometrial carcinoma.
Patients and methods: From january 1997 to march 2002, 86 patients with clinical stage I endometrial carcinoma were studied by pelvic (22) or abdomino-pelvic (64) MRI. The size and signal of lesions and junctional zone, the enhancement after contrast administration, the associated benign lesions and the pelvic and lumbo-aortic lymph nodes were assessed without knowledge of surgical results in viewing to identify pitfalls in MRI staging.
Results: MRI allows correct staging in 81.4% (70/86) of cases. Nine cases of false negative on T2 weighted images were correctly staged after contrast administration and dynamic study. Limits of MRI are due to presence of thin or lack of junctional zone, polyps, myomas, adenomyosis, intra cavitary bleeding, and myometrium thinning by large tumors. Eighteen patients were N+, with MRI sensitivity of 82% and specificity of 94%.
Conclusion: MRI is the best modality for pretherapeutic assessment of endometrial carcinoma. MRI allows to choose type of surgery: laparoscopy or laparotomy and define volume of radiotherapy.