Practical MRI of Endometrial Neoplasms, Part 2: MRI and FIGO Staging

Abstract

MRI is the method of choice for the evaluation of endometrial carcinomas (ECs), from detection to evaluation of recurrent disease. Although the staging of ECs is done surgically using the system of the International Federation of Gynecology and Obstetrics (FIGO), preoperative assessment based on MRI findings helps in risk stratification and decision-making. The main parameters evaluated include the degree and depth of myometrial invasion, parametrial extent, and cervical stromal infiltration. The combination of T2-weighted imaging, dynamic contrast-enhanced MRI, and diffusion-weighted imaging increases the accuracy of EC diagnosis and staging. A proposed step-by-step guide was developed to help the radiologist formulate hypotheses and guide clinical reasoning from the approach of the patient to the preparation of the final report. A structured report is also proposed with the objective of improving report quality and facilitating communication with the treating physicians.