Accuracy of Magnetic Resonance Imaging in Staging Endometrial Cancer: A Retrospective Single-center Observational Study

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BSTRACT


Background:
Cancer of endometrium is among the most common female malignancies in developed nations. Usually, because of awareness related to complaints of postmenopausal bleeding and availability of various diagnostic modalities, endometrial cancer has a favorable prognosis. The aim of this study is to determine how accurate the contrast-enhanced magnetic resonance imaging (MRI) is for preoperative staging of uterine cancer considering final histopathological report as gold standard.


Materials and Methods:
In this retrospective study done in a tertiary care center, 50 patients with histopathological diagnosis of endometrial carcinoma were included, operated at our center between January 2024 and December 2024. Various prognostic factors such as invasion of myometrium and cervical stroma, metastasis to the lymph nodes (LNs), and extrauterine spread (EUS) were analyzed preoperatively with contrast-enhanced MRI reported by a single radiologist and then compared with final histopathology report. Statistical parameters such as accuracy (Ac), sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of MRI were assessed for each factor.


Results:
The Sn, Sp, Ac, PPV, and NPV of myometrial invasion (MI) diagnosed with MRI were 62.5%, 80.77%, 72%, 75%, and 70%, and these values for cervical invasion were 40%, 100%, 94%, 100%, and 93.75%, respectively. Similar values for LN metastasis were 33.3%, 95.5%, 88%, 50%, and 91.3% and for EUS were 25%, 97.83%, 92%, 50%, and 93.75%, respectively.


Conclusions:
MRI is a sensitive tool for MI with good Ac and Sp for the diagnosis of cervical stromal invasion and LN metastasis before surgery and helps the clinician to plan the surgery accordingly.