The utility of post-diagnostic imaging in cases of atypical endometrial hyperplasia
1Department of Clinical Radiology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.
Aim:
To contribute to the evidence base evaluating the usefulness of preoperative imaging in management of atypical endometrial hyperplasia.
Materials And Methods:
A single-centre retrospective observational study was conducted comparing preoperative, post-diagnostic radiological staging with surgicopathological staging. The effect on patient management and any changes in final histological diagnosis were recorded.
Results:
There were 38 patients who underwent preoperative imaging (32 magnetic resonance imaging [MRI], one MRI and computed tomography [CT], three CT, and two transvaginal ultrasound) for atypical endometrial hyperplasia from 2007 to 2018. Thirty-four women subsequently underwent surgery. The final histopathological diagnosis was upgraded to cancer in 35% (12/34) and downgraded in 38% (13/34). There was good concordance between preoperative CT/MRI and surgicopathological staging. Of the 12 patients with a malignant diagnosis, all were early-stage disease with 11/12 stage IA and 1/12 stage IB.
Conclusion:
Preoperative staging with CT/MRI for atypical endometrial hyperplasia contributed no useful additional information, made no change to patient management, and is therefore not indicated.
