Magnetic resonance (MR) in endometrial carcinoma preoperative evaluation

BACKGROUND: Myometrial invasion of endometrial carcinoma is an important prognostic factor because the degree of myometrial invasion is correlated with the rate of lymphnode metastases and of recurrences. The aim of the study was a preoperative evaluation of endometrial carcinoma by Magnetic Resonance (MR). METHODS: The authors present a prospective study performed on 54 cases of endometrial carcinoma collected at the Department of Gynecology and Obstetrics of the University of Trieste (Italy). All the patients were considered as Stage I after hysteroscopy and endocervical curettage. Prior to surgery all the patients underwent MR at the Department of Radiology of the University of Trieste (Italy) in order to evaluate the depth of myometrial invasion. The surgical procedure included total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic and lomboaortic lymphadenectomy in high risk cases. Statistical evaluation was performed by Fischer's exact test. RESULTS: Statistically significant positive correlation was found (p<0.001) between MR staging and surgical staging. The sensitivity reported in our series for distinguishing between superficial disease (Stage IA and IB) and deep myometrial invasion (Stage IC) was 92%. CONCLUSIONS: Preoperative MR is helpful in selecting patients at high risk of nodal involvement and it is suggested that, although MR is considered an expensive examination, its use should be always considered before surgical treatment of patients with high surgical risk.