Pertinence de l’imagerie dans l’évaluation préopératoire des patientes avec cancer endométrial

Abstract

ObjectivesTo investigate the value of transvaginal sonography, computed tomography and magnetic resonance imaging for the preoperative staging of endometrial cancer. Patients and methodsThe patient group consisted of consecutive women undergoing surgery for endometrial cancer in our institution between January 2000, and September 2012. Clinical data included comorbidities, BMI (kg/m2), preoperative imaging findings, surgical procedures, surgical International Federation of Gynecology and Obstetrics stage, histological grade, relevant prognostic factors. The pathological data from surgical staging were compared with the preoperative imaging results. ResultsTwo hundred and forty-four patients with the final diagnosis of endometrial cancer were enrolled. Hundred and ninety-six had preoperative transvaginal ultrasonography, 56 preoperative computed tomography and 158 preoperative MRI assessment. In our analysis, MRI had better sensitivity and specificity for all imaging criteria but lymph node assessment where MRI and CT-scan are equivalent (MRI: Se=45.45 %, Sp=79.52 %; CT: Se=50 %, Sp=80 %). Discussion and conclusionIn patients with endometrial cancer, preoperative MRI may not accurately diagnose absence of myometrial invasion. This data should be kept in mind before planning the operative treatment modality and particularly before choosing patients for conservative endometrial carcinoma treatment.