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EV134/#812  Efficacy of preoperative MRI for cancer prediction in patients with endometrial intraepithelial neoplasia/atypical endometrial hyperplasia
  1. Ji Hyun Lee1,
  2. Dae Chul Jung2,
  3. Yong Jae Lee1,
  4. Jung-Yun Lee1,
  5. Sunghoon Kim1,
  6. Sang Wun Kim1,
  7. Young Tae Kim1 and
  8. Eun Ji Nam1
  1. 1Gynecologic Cancer Center, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea, Republic of
  2. 2Radiology, Yonsei University College of Medicine, Seoul, Korea, Republic of

Abstract

Introduction The prevalence of concurrent endometrial cancer in patients with EIN/AEH undergoing hysterectomy approaches 30 to nearly 50%. But there is no effective tool to predict concurrent endometrial cancer among patients with EIN/AH. We investigated whether magnetic resonance imaging (MRI) may predict endometrial cancer in patient with biopsy-proven EIN/AEH.

Methods In this retrospective, single center study, patients with histologically proven EIN/AEH were preoperatively assessed by MRI. All patients underwent total hysterectomy within 4 months. A radiologist reviewed all MRI images except for the cases with no evidence of disease at initial reading. The readings were compared with the final pathologic diagnosis.

Results Between January 1, 2016 and January 5, 2024, a total of 52 patients were included in the study. Endometrial cancer were detected in 15 and all were endometrioid type, grade 1. Baseline characteristics were balanced between two groups. The MRI exhibited a sensitivity of 26.7 (4 out of 15), a specificity of 94.6%, (35 out of 37). The positive predictive value was found to be 66.7% (4 out of 6) and the negative predictive value was 76.1% (35 out of 46). The accuracy of the MRI was calculated to be 75.0% (39 out of 52) and the false positive rate was determined to be 5.4% (2 out of 37).

Conclusion/Implications The pelvic MRI performed well for the preoperative prediction of endometrial cancer in patients with biopsy-proven EIN and may be used as a supplementary tool to evaluate baseline status of provide individualized treatment plans for patients with EIN/AEH.

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