Endometrial cancer MRI

Endometrial cancer Microchapters
Home
Patient Information
Overview
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Endometrial cancer from other Diseases
Epidemiology and Demographics
Risk factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Ultrasound
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Endometrial cancer MRI On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Endometrial cancer MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Endometrial cancer MRI
CDC on Endometrial cancer MRI
Endometrial cancer MRI in the news
Blogs on Endometrial cancer MRI
Directions to Hospitals Treating Endometrial cancer
Risk calculators and risk factors for Endometrial cancer MRI

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

Pelvic MRI may be diagnostic of endometrial cancer.

Pelvic MRI

A dedicated pelvic MRI protocol is recommended for optimal assessment. 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

MR Imaging findings according to FIGO stage

• stage 1: tumour confined to uterus

• stage 1a: tumour confined to the uterine endometrium

• normal or widened endometrium
• normal low T2 signal junctional zone
• complete subendometrial enhancement on T1 contrast imaging

• stage 1b: invasion of less than half of the myometrium

• disruption or irregularity of the low T2 signal junctional zone
• disruption of subendometrial early enhancement

• stage 1c: invasion of outer half of myometrium

• disruption or irregularity of the low T2 signal junctional zone
• disruption of subendometrial early enhancement
• preservation of band of outer myometrium

• stage 2: tumour extends to cervix

• stage 2a

• widening of internal os and endocervical canal by high/isointense T2W signal tumour mass.
• intact low T2W signal of normal cervical stroma

• stage 2b

• widening of internal os and endocervical canal by high/isointense T2W signal tumour mass
• disruption of low T2 signal cervical stroma

• stage 3: tumour extension beyond the uterus

• stage 3a

• irregularity to the uterine contour
• disruption of low T2 signal uterine serosa

• stage 3b

• thickening of vaginal wall
• high T2 signal tumour infiltrating low signal vaginal wall

• stage 3c

• pelvic/para aortic lymph node involvement
• short axis >/= 8 mm in pelvic nodes

• stage 4: bladder/rectal or distant metastasis

• stage 4a

• disruption of low T2 signal bladder or rectal wall
• intraluminal bladder mass

Stage	Findings
Stage I	Tumor confined to the corpus uteri	normal or widened endometrium	normal low T2 signal junctional zone
	IA	No or less than half myometrial invasion
	IB	Invasion equal to or more than half of the myometrium
	Stage II	Tumor invades cervical stroma but does not extend beyond the uterus
Stage III	Local and/or regional spread of the tumor
IIIA	Tumor invades the serosa of the corpus uteri and/or adnexae
IIIB	Vaginal involvement and/or parametrial involvement
III C	Metastases to pelvic and/or para-aortic lymph nodes
	(i) Positive pelvic nodes
	(ii) Positive para-aortic nodes with or without positive pelvic lymph nodes
Stage IV	Tumor invades bladder and/or bowel mucosa, and/or distant metastases
IVA	Tumor invasion of bladder and/or bowel mucosa
IVB	Distant metastasis, including intra-abdominal metastases and/or inguinal nodes