Assessment of Myometrial Invasion in Premenopausal Grade 1 Endometrial Carcinoma: Is Magnetic Resonance Imaging a Reliable Tool in Selecting Patients for Fertility-Preserving Therapy?

作者：Sakane Makoto^*; Hori Masatoshi; Onishi Hiromitsu; Tsuboyama Takahiro; Ota Takashi; Tatsumi Mitsuaki; Ueda Yutaka; Kimura Toshihiro; Kimura Tadashi; Tomiyama Noriyuki

来源：Journal of Computer Assisted Tomography, 2018, 42(3): 412-417.

DOI：10.1097/RCT.0000000000000689

• endometrial carcinoma
• fertility-preserving treatment
• myometrial invasion
• premenopausal woman
• magnetic resonance imaging

Objectives The aim of this study was to evaluate the diagnostic ability of magnetic resonance imaging (MRI) in premenopausal women with G1 endometrial carcinoma.
Methods Twenty-six patients underwent T2W, diffusion weighted, and dynamic contrast-enhanced 3-T MRI. The degree of myometrial invasion was pathologically classified into no invasion, shallow (3 mm or less), and more. Two radiologists assessed myometrial invasion on MRI. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values, AUC, and interobserver agreement were analyzed.
Results For assessing myometrial invasion, mean accuracy, sensitivity, specificity, positive predictive values, negative predictive values, and AUC, respectively, were as follows: 63%, 42%, 85%, 79%, 47%, and 0.75. Mean interobserver agreement was fair (k = 0.36). Shallow invasions were underestimated as no invasion on MRI in all 6 cases.
Conclusions Magnetic resonance imaging produced false-negative result on half of patients. The misjudgments tended to happen in patients with shallow invasion.

• 出版日期2018-6