Magnetic resonance imaging determination of myometrial invasion in endometrial carcinoma

Fifteen patients with FIGO stage I biopsy confirmed endometrial adenocarcinoma underwent preoperative pelvic magnetic resonance imaging (MRI) to evaluate the presence and depth of myometrial invasion. Imaging was performed with a Diasonics superconducting imaging system operating at 0.35 T (15 MHz); multislice multi-spin-echo pulse sequences were used exclusively, with 5-mm contiguous sections. All patients then received primary therapy consisting of abdominal hysterectomy and bilateral salpingo-oophorectomy. Imaging findings were then compared with the uterine specimen histopathology. MRI was accurate in predicting the presence or absence of invasion in 13 of 15 cases (87%) and was able to discriminate superficial from deep invasion in 9 of 11 cases (82%). Based on our findings, we conclude that MRI appears to be an excellent technique for determining myometrial invasion, and that it may play a significant role in the preoperative planning of a thorough search for lymphatic spread in those patients considered to be at high risk by virtue of myometrial invasion.