Myometrial Invasion In Endometrial Cancer Patients: Can Magnetic Resonance Imaging Predict The Myometrial Invasion Before Surgery?

Yıl 2016, Cilt: 13 Sayı: 2, 55 - 57, 01.04.2016

Funda Atalay Kadir Çetinkaya

Öz

Aim: The aim of this study is to investigate the value of magnetic resonans imaging MRI for detecting preoperative myometrial invasion Ml in endometrial EC cancer patients.Material and Methods: Among EC patients with preoperative MRI were included in this study. The data of patients were recorded from their files. MRI reports and MI status in final pathological examination after surgery were compared. The predicting value for MI presence was evaluated.Results: Totally, 38 patients who were obtained preoperative MRI enrolled into the study. The age of the patients were between 37-87, mean 58,8±1,2. The EC was diagnosed by endometial biopsy. All patients were surgically staged as total abdminal hysterectomy, bilateral salphingooopherectomy, pelvic paraaortic lymphadenectomy. The sensitivity, specifity and diagnostic accuracy of MRI assessment of MI were 66,6%, 100% and 68.4%, respectively.Conclusion: The assessment of the MI presence in EC patients by preoperative MRI is a valuable method.

Anahtar Kelimeler

Magnetic resonance imaging, endometrial cancer, myometrial invasion

Endometrium Kanserli Hastalarda Miyometrial İnvazyon: Ameliyat Öncesi Magnetik Rezonans Görüntüleme İnvazyonu Tahmin Edebilir Mi?

Öz

Amaç: Endometrium kanseri EK tanısı almış hastalarda, ameliyat öncesi miyometrial invazyon Mİ ’nun saptanmasında magnetik rezonans MR görüntülemenin değerinin araştırılması amaçlandı.Gereç ve Yöntemler: EK tanısı alan hastalardan ameliyat öncesi MR görüntüleme yapılanlar çalışmaya dahil edildi. Hastaların görüntüleme bilgileri, operasyon bilgileri, patoloji sonuçları dosyalarından alınarak kaydedildi. MR raporlarında Mİ durumları ile ameliyat sonrası patolojik incelemede tespit edilen Mİ durumları karşılaştırılarak bu görüntüleme yönteminin, EK’nde Mİ varlığını tahmin etmedeki rolü değerlendirildi.Bulgular: Ameliyat öncesi MR ile görüntüleme yapılan 38 hasta çalışmaya dahil edildi. Hastaların yaşları 37-87 arasında olup, ortalama 58,8±1,2 bulundu. Bu hastalar endometrial biyopsi yapılarak EK tanısı almıştı. Tüm hastalar cerrahi olarak total abdominal histerektomi, bilateral salpingooferektomi, pelvik paraaortik lenfadenektomi ile evrelendirildi. MR yöntemi ile EK tanılı hastada Mİ tespitinde duyarlılık, özgüllük, doğruluk sırasıyla, %66,6, %100, %68,4 olarak tespit edildi.Sonuç: EK’inde Mİ varlığını değerlendirmede, ameliyat öncesi MR görüntülemenin önemli bir yöntem olduğu izlendi.

Anahtar Kelimeler

Magnetik rezonans görüntüleme, endometrium kanseri, miyometrial invazyon

Kaynakça

• Atalay F, Çetinkaya K, Bacınoglu A. Is the 2009 FIGO staging system really valuable for stage I endometrial cancer? Eur J Gynecol Oncol 2013. 34:556-8.
• Chi DS, Barakat RR, Palayekar MJ, et al. The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrial histology. Int J Gy- necol Cancer 2008. 18:269-73.
• Mariani A, Webb MJ, Keeney GL, et al. Low risk corpus cancer: is lym- phadenectomy or radiotherapy necessary? Am J Obstet Gynecol 2000. 182:1506-19.
• Benedetti PP, Basile S, Maneshci F, et al. Systematic pelvic lymphadene- ctomy vs no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst 2008.100:1707-16.
• Patel S, Liyanage SH, Sadhev A, et al. Imaging of endometrial and cervi- cal cancer. Insights Imaging 2010, 1:309-28.
• Cetinkaya K, Atalay F, Bacinoglu A. Risk factors of lymph node metasta- ses with endometrial carcinoma Asian Pas J Can Prev, 2014,15:6353- 56.
• Hricak H, Stern JL, Fisher MR, et al. Endometrial carcinoma staging by MR imaging. Radiology 1987, 162:297-305.
• Koyama T, Tamai K, Togashi K. Sataging of carcinoma of the uterine cer- vix and endometrium. Eur Radiol, 2007, 17: 2009-19.
• Pecorelli S (2009) Revised FIGO staging for carcinoma of the vulva, cer- vix, and endometrium. Int J Gynaecol Obstet 105:103–104.
• Todo Y, Kato H, Kaneuchi M, et al. Survival effect of para-aortic lympha- denectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet 2010, 375:1165–1172.
• Amant F, Moerman P, Neven P, et al. Endometrial cancer. Lancet 2005, 366:491–505
• Creasman WT, Morrow CP, Bundy BN, et al. Surgical pathologic spread patterns ofendometrial cancer. A Gynecologic Oncology Group Study. Cancer 1987, 60:2035–2041.
• Weber G, Merz E, Bahlmann F, et al.Assessment of myometrial infiltration and preoperative staging by transvaginal ultrasound in patients with en- dometrialcarcinoma. Ultrasound Obstet Gynecol 1995, 6:362–367.
• Hardesty LA, Sumkin JH, Hakim C, et al. The ability of helical CT to pre- operatively stage endometrial carcinoma. AJR Am J Roentgenol 2001, 176:603–606.
• Connor JP, Andrews JI, Anderson B, et al. Computed tomography in en- dometrial carcinoma. Obstet Gynecol 2000, 95:692–696 .
• Faria SC, Sagebiel T, Balachandran A, et al. Imaging in endometrial carci- noma. Ind J Radiol Imaging, 2015,25:137-47.
• Barwick TD, Rockall AG, Barton DP, et al. Imaging of endometrial carci- noma. Clin Radiol 2007, 61: 545-55.
• Gallego JC, Porta A, Pardo MC, et. al. Evaluation of myometrial invasi- on in endometrial cancer: comparison of diffusion-weighted magnetic resonance and intraoperative frozen sections. Abdom Imaging. 2014 ;39:1021-6.