Magnetic resonance imaging (MRI) in endometrial carcinoma; preoperative estimation of depth of myometrial invasion.

Background: The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on both tumor differentiation grade and myometrial invasion depth. It was evaluated whether magnetic resonance imaging (MRI) provides a preoperative technique to assess the depth of myometrial invasion.

Methods: The study includes 34 patients with an endometrial carcinoma. MRI (T5 Gyroscan, Philips) was made a few days before operation. Myometrial invasion was divided in four categories. Cervical invasion was classified as absent, superficial or deep. For comparison an in vitro MRI of the uterus was made directly after the operation. Histo-pathological examination of the uterus was used as a golden standard of the depth of myometrial invasion.

Results: The estimation by MRI of the myometrial invasion depth was correct in 25 out of 31 patients. In three patients estimation was not possible, because of bad image quality. In four patients the MRI underestimated the cervical invasion.

Conclusions: Preoperative MRI in patients with an endometrial carcinoma can be used to estimate myometrial and cervical invasion. Therefore, in combination with the histological grading of the tumor, a preoperative MRI can be used to select patients at high risk of nodal involvement.