Introduction/Background Endometrial carcinoma is the most common gynecological tumor in developed countries. Clinical-pathological factors and molecular sub-types are used to stratify the risk of recurrence and to tailor adjuvant treatment. The main limitation of molecular and clinicopathological prognostic factors is the need of post-operative surgical specimens, obtained through comprehensive surgical staging. Since preoperative endometrial sampling performed for tumor diagnosis represents the collection of only a portion of the whole tumor, it may result in sampling errors. The present study aims to assess the role of radiomics analysis in preoperatively predicting molecular or clinical-pathological prognostic factors in patients with endometrial carcinoma.

Methodology Literature was searched for manuscripts reporting radiomics analysis in assessing diagnostic performance of Magnetic Resonance Imaging (MRI) for different outcomes. Diagnostic accuracy performance of risk prediction models was pooled using the metandi command in Stata.

Results A search of MEDLINE (PubMed) resulted in 153 relevant articles. Fifteen articles met inclusion criteria, for a total of 3608 patients. MRI showed pooled sensitivity and specificity 0.785 and 0.814, respectively in predicting high grade endometrial carcinoma, deep myometrial invasion (pooled sensitivity and specificity 0.743 and 0.816, respectively), lymphovascular space invasion (pooled sensitivity and specificity 0.656 and 0.753, respectively), nodal metastasis (pooled sensitivity and specificity 0.831 and 0.736, respectively).

Conclusion Preoperative MRI-radiomics analyses in patients with endometrial carcinoma is a good predictor of tumor grading, deep myometrial invasion, lymphovascular space invasion, and nodal metastasis.

Disclosures there are no conflicts of interest