Magnetic resonance imaging in pre-operative staging of endometrial cancer.

Abstract

Endometrial cancer (EC) is one of the most common gynecological cancers and the fourth most common cancer in the female. Although clinical evaluation with diagnostic imaging has not yet proved to be accurate enough in the evaluation of tumor extent to replace surgical staging, it may enable optimization of the surgical procedure and a better tailored therapeutic strategy. This study will review the characteristic magnetic resonance imaging (MRI) findings in endometrial carcinomas in the pre-operative staging of endometrial carcinomas and compare it with the newly revised Federation of Gynecology and Obstetrics (FIGO) staging scheme of 2009 based on post-operative surgical histopathology. It is a retrospective analysis of 36 patients diagnosed and treated for endometrial carcinoma in our institute from January 2009 to December 2012. Majority of the patients (61%) were between the age group of 41-60 years. Most of the patients (72%) were postmenopausal at the time of presentation. Most common histopathology of endometrial carcinoma was endometroid adenocarcinoma (27 patients, 75%). FIGO staging of 12 patients (85.7%) showed concordance with MRI Staging for Stage Ia, with up-gradation of two patients to Stage Ib. The information provided by MRI can define prognosis, help planning the surgical approach and identify those patients requiring neoadjuvant chemotherapy or radiation therapy.