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European Radiology
Published in: European Radiology 2/2013

01-02-2013 | Magnetic Resonance

Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies

Authors: Lian-Ming Wu, Jian-Rong Xu, Hai-Yan Gu, Jia Hua, E. Mark Haacke, Jiani Hu

Published in: European Radiology | Issue 2/2013

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Abstract

Background

To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer.

Methods

Databases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis.

Results

Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05).

Conclusions

CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making.

Key Points

• CE-MRI is widely used for endometrial carcinoma
• CE-MRI has a good performance in the prediction of any myometrial invasion
• CE-MRI is superior to T2WI in the prediction of any myometrial invasion
• For assessing deep myometrial involvement, its NPV appears relatively high
Literature
1.
National Cancer Institute (2010) Cancer stat fact sheets: sorpus and uterus, NOS. National Cancer Institute, Bethesda
2.
3.
Larson DM, Connor GP, Broste SK, Krawisz BR, Johnson KK (1996) Prognostic significance of gross myometrial invasion with endometrial cancer. Obstet Gynecol 88:394–398PubMedCrossRef
4.
Berman ML, Ballon SC, Lagasse LD, Watring WG (1980) Prognosis and treatment of endometrial cancer. Am J Obstet Gynecol 136:679–688PubMed
5.
6.
Boronow RC, Morrow CP, Creasman WT et al (1984) Surgical staging in endometrial cancer: clinical-pathologic findings of a prospective study. Obstet Gynecol 63:825–832PubMed
7.
Benedetti Panici P, Basile S, Maneschi F et al (2008) Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst 100:1707–1716PubMedCrossRef
8.
Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 373:125–136PubMedCrossRef
9.
Wang CB, Wang CJ, Huang HJ et al (2002) Fertility-preserving treatment in young patients with endometrial adenocarcinoma. Cancer 94:2192–2198PubMedCrossRef
10.
Manfredi R, Mirk P, Maresca G et al (2004) Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology 231:372–378PubMedCrossRef
11.
Sala E, Crawford R, Senior E et al (2009) Added value of dynamic contrast-enhanced magnetic resonance imaging in predicting advanced stage disease in patients with endometrial carcinoma. Int J Gynecol Cancer 19:141–146PubMedCrossRef
12.
Kinkel K, Forstner R, Danza FM et al (2009) Staging of endometrial cancer with MRI: guidelines of the European Society of Urogenital Imaging. Eur Radiol 19:1565–1574PubMedCrossRef
13.
Ito K, Matsumoto T, Nakada T, Nakanishi T, Fujita N, Yamashita H (1994) Assessing myometrial invasion by endometrial carcinoma with dynamic MRI. J Comput Assist Tomogr 18:77–86PubMedCrossRef
14.
Nakao Y, Yokoyama M, Hara K et al (2006) MR imaging in endometrial carcinoma as a diagnostic tool for the absence of myometrial invasion. Gynecol Oncol 102:343–347PubMedCrossRef
15.
Seki H, Kimura M, Sakai K (1997) Myometrial invasion of endometrial carcinoma: assessment with dynamic MR and contrast-enhanced T1-weighted images. Clin Radiol 52:18–23PubMedCrossRef
16.
Sironi S, Colombo E, Villa G et al (1992) Myometrial invasion by endometrial carcinoma: assessment with plain and gadolinium-enhanced MR imaging. Radiology 185:207–212PubMed
17.
Yamashita Y, Harada M, Sawada T, Takahashi M, Miyazaki K, Okamura H (1993) Normal uterus and FIGO stage I endometrial carcinoma: dynamic gadolinium-enhanced MR imaging. Radiology 186:495–501PubMed
18.
Rockall AG, Meroni R, Sohaib SA et al (2007) Evaluation of endometrial carcinoma on magnetic resonance imaging. Int J Gynecol Cancer 17:188–196PubMedCrossRef
19.
Chung HH, Kang SB, Cho JY et al (2007) Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol 104:654–659PubMedCrossRef
20.
Deville WL, Bezemer PD, Bouter LM (2000) Publications on diagnostic test evaluation in family medicine journals: an optimal search strategy. J Clin Epidemiol 53:65–69PubMedCrossRef
21.
Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25PubMedCrossRef
22.
Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893PubMedCrossRef
23.
Haldorsen IS, Husby JA, Werner HM et al (2012) Standard 1.5-T MRI of endometrial carcinomas: modest agreement between radiologists. Eur Radiol 22:1601–1611PubMedCrossRef
24.
Emlik D, Kiresi D, Ozdemir S, Celik C, Karakose S (2010) Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma: comparison of multi-section dynamic MR imaging using a three dimensional FLASH technique and T2-weighted MR imaging. J Med Imaging Radiat Oncol 54:202–210PubMedCrossRef
25.
Chang SJ, Lee EJ, Kim WY et al (2010) Value of sonohysterography in preoperative assessment of myometrial invasion for patients with endometrial cancer. J Ultrasound Med 29:923–929PubMed
26.
Rechichi G, Galimberti S, Signorelli M, Perego P, Valsecchi MG, Sironi S (2010) Myometrial invasion in endometrial cancer: diagnostic performance of diffusion-weighted MR imaging at 1.5-T. Eur Radiol 20:754–762PubMedCrossRef
27.
Ozdemir S, Celik C, Emlik D, Kiresi D, Esen H (2009) Assessment of myometrial invasion in endometrial cancer by transvaginal sonography, Doppler ultrasonography, magnetic resonance imaging and frozen section. Int J Gynecol Cancer 19:1085–1090PubMedCrossRef
28.
Lin G, Ng KK, Chang CJ et al (2009) Myometrial invasion in endometrial cancer: diagnostic accuracy of diffusion-weighted 3.0-T MR imaging—initial experience. Radiology 250:784–792PubMedCrossRef
29.
Hori M, Kim T, Murakami T et al (2009) MR imaging of endometrial carcinoma for preoperative staging at 3.0 T: comparison with imaging at 1.5 T. J Magn Reson Imaging 30:621–630PubMedCrossRef
30.
Savelli L, Ceccarini M, Ludovisi M et al (2008) Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging. Ultrasound Obstet Gynecol 31:560–566PubMedCrossRef
31.
Savci G, Ozyaman T, Tutar M, Bilgin T, Erol O, Tuncel E (1998) Assessment of depth of myometrial invasion by endometrial carcinoma: comparison of T2-weighted SE and contrast-enhanced dynamic GRE MR imaging. Eur Radiol 8:218–223PubMedCrossRef
32.
Deeks JJ (2001) Systematic reviews in health care: systematic reviews of evaluations of diagnostic and screening tests. BMJ 323:157–162PubMedCrossRef
33.
Kinkel K, Kaji Y, Yu KK et al (1999) Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology 212:711–718PubMed
34.
Frei KA, Kinkel K, Bonel HM, Lu Y, Zaloudek C, Hricak H (2000) Prediction of deep myometrial invasion in patients with endometrial cancer: clinical utility of contrast-enhanced MR imaging-a meta-analysis and Bayesian analysis. Radiology 216:444–449PubMed
35.
Reitsma JB, Glas AS, Rutjes AW, Scholten RJ, Bossuyt PM, Zwinderman AH (2005) Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol 58:982–990PubMedCrossRef
36.
Chu H, Cole SR (2006) Bivariate meta-analysis of sensitivity and specificity with sparse data: a generalized linear mixed model approach. J Clin Epidemiol 59:1331–1332, author reply 1332–1333PubMedCrossRef
Metadata
Title
Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies
Authors
Lian-Ming Wu
Jian-Rong Xu
Hai-Yan Gu
Jia Hua
E. Mark Haacke
Jiani Hu
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2609-9

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