Endometrial cancer MRI: Difference between revisions

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| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''IB'''
| rowspan=3 style="padding: 5px 5px; background: #DCDCDC;" | '''IB'''
| style="padding: 5px 5px; background: #F5F5F5;" | Invasion equal to or more than half of the [[myometrium]]
| style="padding: 5px 5px; background: #F5F5F5;" | Invasion equal to or more than half of the [[myometrium]]|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Stage II'''
| style="padding: 5px 5px; background: #DCDCDC;" |'''Stage II'''
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invades cervical stroma but does not extend beyond the [[uterus]]
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invades cervical stroma but does not extend beyond the [[uterus]]
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Stage III'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''Stage III'''
| style="padding: 5px 5px; background: #F5F5F5;" | Local and/or regional spread of the tumor
| style="padding: 5px 5px; background: #F5F5F5;" | Local and/or regional spread of the tumor
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
|style="padding: 5px 5px; background: #DCDCDC;" |'''IIIA'''
|style="padding: 5px 5px; background: #DCDCDC;" |'''IIIA'''
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invades the serosa of the corpus uteri and/or adnexae
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invades the serosa of the corpus uteri and/or adnexae
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''IIIB'''
| style="padding: 5px 5px; background: #DCDCDC;" |'''IIIB'''
| style="padding: 5px 5px; background: #F5F5F5;" | Vaginal involvement and/or parametrial involvement
| style="padding: 5px 5px; background: #F5F5F5;" | Vaginal involvement and/or parametrial involvement
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| rowspan=3 style="padding: 5px 5px; background: #DCDCDC;" | '''III C'''
| rowspan=3 style="padding: 5px 5px; background: #DCDCDC;" | '''III C'''
Line 92: Line 121:
| style="padding: 5px 5px; background: #DCDCDC;" | '''IVA'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''IVA'''
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invasion of [[bladder]] and/or bowel mucosa
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor invasion of [[bladder]] and/or bowel mucosa
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''IVB'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''IVB'''
| style="padding: 5px 5px; background: #F5F5F5;" | Distant metastasis, including intra-abdominal [[metastases]] and/or inguinal nodes
| style="padding: 5px 5px; background: #F5F5F5;" | Distant metastasis, including intra-abdominal [[metastases]] and/or inguinal nodes
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal or widened endometrium
|-
| style="padding: 5px 5px; background: #F5F5F5;" | normal low T2 signal junctional zone
|-
| style="padding: 5px 5px; background: #F5F5F5;" | complete subendometrial enhancement on T1 contrast imaging
|-
|-
|}
|}

Revision as of 15:48, 23 September 2015

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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

Pelvic MRI may be diagnostic of endometrial cancer.

Pelvic MRI

A dedicated pelvic MRI protocol is recommended for optimal assessment.[1] 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 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 MRI Findings
Stage I Tumor confined to the corpus uteri
IA No or less than half myometrial invasion
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
IB Invasion equal to or more than half of the myometrium|- normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
Stage II Tumor invades cervical stroma but does not extend beyond the uterus
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
Stage III Local and/or regional spread of the tumor
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
IIIA Tumor invades the serosa of the corpus uteri and/or adnexae
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
IIIB Vaginal involvement and/or parametrial involvement
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
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
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging
IVB Distant metastasis, including intra-abdominal metastases and/or inguinal nodes
normal or widened endometrium
normal low T2 signal junctional zone
complete subendometrial enhancement on T1 contrast imaging

References

  1. ↑ "endometrial cancer MRI".


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