Endometrial cancer MRI: Difference between revisions

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==Overview==
==Overview==
Pelvic MRI may be diagnostic of endometrial cancer. The MRI findings of endometrial cancer vary according to FIGO staging.<ref>{{Cite web | title =endometrial cancer MRI  | url =http://radiopaedia.org/articles/endometrial-carcinoma}}</ref>
The MRI is not needed for the diagnosis of endometrial cancer. However, an MRI may be helpful in staging of the disease.<ref name=":0">{{Cite web | title =endometrial cancer MRI  | url =http://radiopaedia.org/articles/endometrial-carcinoma}}</ref>


==Pelvic MRI==
==Pelvic MRI==
A dedicated [[pelvic]] MRI protocol is recommended for optimal assessment.<ref>{{Cite web | title =endometrial cancer MRI  | url =http://radiopaedia.org/articles/endometrial-carcinoma}}</ref>
The MRI is not needed for the diagnosis of endometrial cancer. However, an MRI may be helpful in staging of the disease.<ref name=":0" />
MRI is considered superior to CT for local staging. Contrast enhanced MRI imaging improves accuracy in detecting myometrial invasion.
* T1: hypo- to isointense to normal [[endometrium]]
* T1 C+(Gd): carcinomatous tissue will enhance less than normal endometrium
* T2: hyperintense or heterogeneous relative to normal endometrium


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'''MR Imaging findings according to FIGO stage'''
'''MR Imaging findings according to FIGO stage'''
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage of endometrial cancer}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage of endometrial cancer}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|MRI findings}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|MRI findings}}
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Stage 1: tumour confined to uterus
Stage 1: tumor confined to uterus
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:1a.
:1a.
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Stage 2: tumour extends to cervix
Stage 2: tumor extends to cervix
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:* Widening of internal os and endocervical canal by high/isointense T2W signal tumour mass.
:* Widening of internal os and endocervical canal by high/isointense T2W signal tumor mass.
:* Intact low T2W signal of normal cervical stroma
:* Intact low T2W signal of normal cervical stroma
:* Disruption of low T2 signal cervical stroma
:* Disruption of low T2 signal cervical stroma
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Stage 3: tumour extension beyond the uterus
Stage 3: tumor extension beyond the uterus
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:3b
:3b
:* Thickening of vaginal wall
:* Thickening of vaginal wall
:* High T2 signal tumour infiltrating low signal vaginal wall
:* High T2 signal tumor infiltrating low signal vaginal wall
:3c
:3c
:* Pelvic/para aortic lymph node involvement
:* Pelvic/para aortic lymph node involvement
:* Short axis >/= 8 mm in pelvic nodes
:* Short axis ≥ 8 mm in pelvic nodes
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Stage 4: bladder/rectal or distant metastasis
Stage 4: bladder/rectal or distant metastasis
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Latest revision as of 14:42, 29 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

The MRI is not needed for the diagnosis of endometrial cancer. However, an MRI may be helpful in staging of the disease.[1]

Pelvic MRI

The MRI is not needed for the diagnosis of endometrial cancer. However, an MRI may be helpful in staging of the disease.[1]

MR Imaging findings according to FIGO stage
Stage of endometrial cancer MRI findings

Stage 1: tumor confined to uterus

1a.
  • Disruption or irregularity of the low T2 signal junctional zone
  • Disruption of subendometrial early enhancement
1b.
  • Disruption or irregularity of the low T2 signal junctional zone
  • Disruption of subendometrial early enhancement
  • Preservation of band of outer myometrium

Stage 2: tumor extends to cervix

  • Widening of internal os and endocervical canal by high/isointense T2W signal tumor mass.
  • Intact low T2W signal of normal cervical stroma
  • Disruption of low T2 signal cervical stroma

Stage 3: tumor extension beyond the uterus

3a
  • Irregularity to the uterine contour
  • Disruption of low T2 signal uterine serosa
3b
  • Thickening of vaginal wall
  • High T2 signal tumor infiltrating low signal vaginal wall
3c
  • Pelvic/para aortic lymph node involvement
  • Short axis ≥ 8 mm in pelvic nodes

Stage 4: bladder/rectal or distant metastasis

4a
  • Disruption of low T2 signal bladder or rectal wall
  • Intraluminal bladder mass

References

  1. ↑ 1.0 1.1 "endometrial cancer MRI".


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