Role of Preoperative DWI-MRI and Dynamic Contrast Enhanced MRI in Predicting Aggressive Disease in Endometrial Carcinoma

Abstract

Endometrial cancer is the most common gynecologic cancer seen in postmenopausal women over the age of 50 years. Endometrial cancer is curable, especially in the early stages. Accurate mapping of the extent of cancer spread is important for appropriate application of local and/or regional treatment. Although endometrial cancer is surgically staged, the identification of disease extent in particular extrauterine spread prior to surgery is important to optimize treatment planning. MRI is the best tool for preoperatively assessing myometrial invasion depth and cervical involvement which correlate with tumor grade, presence of LN metastases, and overall survival. The combination of T2-weighted imaging (T2WI), dynamic contrast-enhanced (DCE) MR imaging, and diffusion-weighted imaging (DWI) offers the best diagnostic accuracy in staging of endometrial cancer. This study aimed to evaluate the accuracy of DWI and dynamic contrast enhanced MRI in preoperative staging of endometrial carcinoma and prediction of severity of the disease prior to surgery. The study was cross sectional study included 20 patients referred from the Gynecology Department to the Radiology Department in Ain Shams University hospitals. They were all presented with postmenopausal bleeding or menorrhagia. Patients presented with a histologic diagnosis of endometrial carcinoma.