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1155 Accuracy of contrast-enhanced magnetic resonance imaging (MRI) for miometrial invasion in early stage endometrial carcinoma
  1. Marta Ibañez Nieto,
  2. Victoria Pascual Escudero,
  3. Emilio Bayon Alvarez,
  4. Paula Suarez Mansilla,
  5. Susana Cortes Perez,
  6. Jose Ignacio Gonzalez Martin,
  7. Alvaro Sanz Diaz-Heredero,
  8. Esther Ruiz Perez,
  9. Lidia Casamyor Del Nogal,
  10. Jimena Bayon Pascual,
  11. Sandra Canales Martinez,
  12. Julio Alberto Gobernado Tejedor,
  13. Monica Simon De La Fuente,
  14. Monica Consuelo Horstmann Sendagorta,
  15. Carmen Elena Badillo Bercebal,
  16. Elena Garcia Garcia and
  17. Juan Jose Fuertes Alija
  1. Hospital Clínico Universitario de Valladolid, Valladolid, Spain


Introduction/Background Endometrial carcinoma (EC) is the most common gynecological malignancy. Despite EC is surgically staged, preoperative imaging studies allow us to know risk factors such as miometrial invasion, cervical involvement and lymph node metastases. For clinical staging, contrast-enhanced magnetic resonance imaging (MRI) appears to be the best modality compared to ultrasound or CT.

Methodology Retrospective, observational study including 166 patients diagnosed with early stage EC (IA-B, II) according to MRI (diffusion and dynamic contrast-enhanced) in our institution between 2016–2022. Variables included were age, previous medical conditions, histological subtype, MRI-preoperative stage, surgery and pathological report. All data were analyzed with SPSS v.23.

Results Mean age was 66.7 years (range 41–92). 50.6 % were hypertensive, 28.3% obese and 20.4% diabetic. 88.6% were postmenopausal women. Regarding histological type, 90.9% were endometrioid EC. We found 65.7 % concordance between MRI preoperative stage and final pathological stage. Concerning miometrial invasion, MRI shows 67.8% sensitivity, 78.5% specificity and NPV 81.6% (p<0.0001). Cervical involvement was reported only in 6 patients, with specificity of 98.1% and NPV 94.4% (p> 0.05) but low sensitivity.

Conclusion The aim of our study was to assess MRI performance in preoperative staging of EC. Sentinel lymph node biopsy was included in 2023 in our institution. In study period, MRI information was crucial to decide extension of surgical treatment.

We matched data obtained from preoperative MRI and final pathological report. According to our results, MRI is a reliable imaging test to assess miometrial invasion. These results are similar to literature background. We weren’t able to extract solid information regarding cervical involvement, because only 6 patients were considered preoperative stage II.

We summarize that MRI can give further preoperative information to determine prognosis, risk group and surgical treatment in early stage EC patients, always depending on each institution availability and specially if SLNB is not feasible.

Disclosures No.

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