Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging
K. Kinkel,Rosemarie Forstner,Francesco Danza,Laura Oleaga,Teresa Margarida Cunha,Antonina Bergman,Jelle O. Barentsz,Corinne Balleyguier,Boris Brkljačić,John A. Spencer +9 more
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TLDR
The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content for endometrial cancer staging with MRI.Abstract:
The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min +/- 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer.read more
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The Added Role of MR Imaging in Treatment Stratification of Patients with Gynecologic Malignancies: What the Radiologist Needs to Know
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Diffusion-weighted single-shot echo-planar imaging with parallel technique in assessment of endometrial cancer.
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TL;DR: DWI performed with parallel imaging technique has potential as a method for differentiating benign from malignant endometrial lesions and also provides valuable information for preoperative evaluation and should be considered part of routine preoperative MRI evaluation forendometrial cancer.
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