Abstract

Background: To evaluate the preoperative diagnostic efficacy of 3D-MRI for the depth of myometrial invasion of endometrial carcinoma. Methods: A total of 116 patients with endometrial carcinoma who had undergone pelvic MRI before surgery were included. Mimics 21.0 (Materialize Co., Belgium) software was used to reconstruct three-dimensional MRI models (3D-MRI). The tumor volume and surface area, uterine volume and surface area were measured, and the tumor volume ratio was calculated. TVR (Tumor Volume Ratio) = tumor volume/uterine volume, TAR (Tumor Area Ratio) = tumor surface area/uterine surface area. Postoperative pathology was used as the gold standard to compare the accuracy, sensitivity, specificity, negative predictive value, and positive predictive value of conventional MRI and 3D-MRI in preoperative assessment of endometrial carcinoma myometrial invasion. Results: The accuracy and specificity of 3D-MRI in the diagnosis of deep myometrial invasion were better than conventional MRI (p < 0.05). There was no statistically significant difference in tumor volume or surface area between stage IA and stage IB (p > 0.05), while TVR and TAR showed significant statistical differences (8.05 ± 0.66 vs. 19.12 ± 3.20, p < 0.01; 21.38 ± 1.04 vs. 35.15 ± 3.42, p < 0.01). Further analysis, the area under the ROC curve of TVR is 0.738, p < 0.01, and the best cut-off value is 13.59%; the area under the ROC curve of TAR is 0.770, p < 0.01, and the best cut-off value is 27.41%. Conclusions: Preoperative 3D-MRI can effectively assess the myometrial invasion of endometrial carcinoma.

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