RT Journal Article SR Electronic T1 #457 The role of preoperative MRI in assessing myometrial invasion in endometrial cancer. Experience from oncology centre opole JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP A161 OP A161 DO 10.1136/ijgc-2023-ESGO.332 VO 33 IS Suppl 3 A1 Mrugala, Maja A1 Nowak, Krzysztof A1 Tomiczek-Szwiec, Joanna A1 Kasperski, Mariusz A1 Milnerowicz-Nabzdyk, Ewa YR 2023 UL http://ijgc.bmj.com/content/33/Suppl_3/A161.2.abstract AB Introduction/Background Endometrial cancer is a common malignancy in women, and accurate staging is crucial for optimal treatment selection. In recent years, preoperative magnetic resonance imaging (MRI) has emerged as an important tool in accurately determining the extent of endometrial cancer. The aim of this study was to evaluate the role of preoperative MRI in assessing myometrial invasion in endometrial cancer patients treated at Oncology Centre Opole.Methodology A retrospective study was conducted on 181 endometrial cancer patients who underwent primary surgery and histopathological assessment at Oncology Centre Opole between 2020–2023. The utility of preoperative MRI in assessing superficial (FIGO IA) and deep (FIGO IB) myometrial invasion was analyzed and compared to histopathological reports. Of the 181 patients, 125 had FIGO stage I disease. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for estimating myometrial invasion by preoperative MRI.Results The sensitivity and specificity of preoperative MRI in assessing FIGO IA were 70% and 78%, respectively. The positive predictive value and negative predictive value were 82% and 64%. For FIGO IB, the sensitivity and specificity of preoperative MRI were 77% and 93%, respectively. The positive predictive value and negative predictive value were 40% and 85%.Conclusion Our results showed that preoperative MRI is an effective tool in assessing myometrial invasion in endometrial cancer patients. However, the low positive predictive value for deep myometrial invasion indicates that the MRI result should also be verified by TVS performed by an experienced clinician and led us to validate the MRI protocol.In conclusion, a multidisciplinary approach involving clinical evaluation, imaging, and histopathological assessment is necessary for accurate staging and further management of endometrial cancer.Disclosures No conflict of interest.