Diagnostic accuracy of pelvic MRI for determination of the cervical involvement in endometrial cancer

Objective: To determine the diagnostic accuracy of pelvic MRI for assessment of the cervical involvement in endometrial cancer. Study Design: Cross-sectional analytical study. Place and Duration of Study: Radiology Department of the Aga Khan University Hospital, Karachi from January 2014 to December 2015. Methodology: Patients with biopsy-proven endometrial cancer were included, who had both their MRI and histopathological diagnosis performed at our institution. Those patients treated with chemo/radiotherapy or had incomplete medical records, were excluded. The extent of cervical involvement by endometrial carcinoma was seen on T2WI images, and findings were correlated after surgery taking histopathology as the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. Results: The mean age of the 56 patients was 60.87 ±8.80 years (range 37-84 years). The most common clinical indication was post-menopausal bleeding (n=37, 66.1%). The most common histological subtype was endometrioid adenocarcinoma (n=50, 89.3%). The sensitivity, specificity, diagnostic accuracy, positive and negative predictive values of MRI in the detection of cervical invasion were 92.85%, 88.09%, 89.28%, 72.22% and 97.36%, respectively. Conclusion: MRI is a highly sensitive and specific imaging modality for detection of cervical invasion in endometrial carcinoma.