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Assessment of Myometrial Invasion in Premenopausal Grade 1 Endometrial Carcinoma

Is Magnetic Resonance Imaging a Reliable Tool in Selecting Patients for Fertility-Preserving Therapy?

Sakane, Makoto, MD, PhD*; Hori, Masatoshi, MD, PhD*; Onishi, Hiromitsu, MD, PhD*; Tsuboyama, Takahiro, MD, PhD*; Ota, Takashi, MD*; Tatsumi, Mitsuaki, MD, PhD*; Ueda, Yutaka, MD, PhD; Kimura, Toshihiro, MD, PhD; Kimura, Tadashi, MD, PhD; Tomiyama, Noriyuki, MD, PhD*

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 412–417
doi: 10.1097/RCT.0000000000000689
Abdominal 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.

From the Departments of *Diagnostic and Interventional Radiology and

Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.

Received for publication June 5, 2017; accepted August 16, 2017.

Correspondence to: Makoto Sakane, MD, Department of Diagnostic and Interventional Radiology, Osaka University Graduate School, D1, 2–2 Yamadaoka, Suita-shi, Osaka, 565–0871 Japan (e-mail:

The authors declare no conflict of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional.

This retrospective study waived the requirement for informed consent under the acceptance of institutional ethical board.

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