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 the stage of the disease and may include presence of localized tumor, invasion to surrounding structures, large pelvic nodes in nodal involvement, and tumors of distant metastasis.<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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