April 2017 · Volume 6 · Issue 4 Page 1630 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Sampath S et al. Int J Reprod Contracept Obstet Gynecol. 2017 Apr;6(4):1630-1634 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Original Research Article Accuracy of MR Imaging in endometrial cancer: our experience Santhanam Sampath*, Devendra Nema, Raju Agarwal, Prasad Lele INTRODUCTION Endometrial cancer is the second commonest gynaecological cancer worldwide. SEER data shows that 83% cases are early stage (FIGO stages I and II) at diagnosis with good 5 year survival rates. Contemporary management of endometrial cancer in most cases is primarily surgical and includes peritoneal fluid cytology, extrafascial hysterectomy with bilateral salpingo- oophorectomy along with removal of bilateral pelvic and paraaortic lymph nodes for complete surgical staging. For FIGO Stage II disease with cervical stromal involvement, a modified Radical hysterectomy is recommended. The baseline rate of nodal involvement inclusive of all stages is around 9%. Removal of negative nodes has not been shown to confer therapeutic benefit however adds significantly to operative, short and long term postoperative morbidity in, what is essentially a disease with good prognosis. A modality to assess the risk of nodal involvement preoperatively and to omit unnecessary nodal dissection with its attendant morbidity, in cases deemed to be at low risk of involvement, is a desirable option. Furthermore, preoperative assessment of cervical stromal involvement would enable the surgeon to plan a Type II radical hysterectomy in these cases to ensure optimal disease outcome. In various studies done in western population, MRI has been shown to be reasonably accurate in identifying enlarged nodes, detection of myometrial invasion and its depth and identification of cervical stromal invasion. The accuracy varies depending on type of MRI sequence used and may be confounded by inflammation associated with previous biopsy. No such study has been carried out in Indian population. The aim of the study is to assess accuracy of preoperative MRI in prediction of deep myometrial invasion and cervical stromal invasion in Indian population managed at a tertiary care centre. ABSTRACT Background: MRI is a useful modality for preoperative imaging in endometrial cancer. We report our experience in Indian population managed at a tertiary care center regarding accuracy of preoperative MRI in prediction of deep myometrial invasion and cervical stromal invasion. Methods: 30 patients with endometrioid adenocarcinoma endometrium on endometrial biopsy underwent preoperative MRI in the week preceding surgery. MRI impression of depth of myometrial invasion, cervical stroma involvement and positive nodes were compared with final histopathology findings to calculate the accuracy of MRI. Results: The accuracy of MRI for estimation of tumour size was 72% and for detection of myometrial invasion was 76%. The accuracy for detection of cervical, adnexal and nodal involvement was 96%, 100% and 96% respectively. Conclusions: MRI is an accurate modality for preoperative assessment in endometrial cancer and can significantly assist in surgical planning. Keywords: Diffusion weighted imaging, DCE MRI, Endometrial carcinoma, Myometrial invasion, Staging Department of Obstetrics and Gynecology, Command Hospital, Lucknow, Uttar Pradesh, India Received: 04 February 2017 Revised: 06 March 2017 Accepted: 06 March 2017 *Correspondence: Dr. Santhanam Sampath, E-mail: sampyster@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20171441