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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The advent of MRI has improved the ability of the diagnostic radiologist to provide useful clinical information to the practicing gynecologist. Although US remains the screening procedure of choice for evaluation of the uterus and adnexa because of its relative safety and low cost, MRI is now considered the next imaging step. In a woman with pelvic pain, MRI can accurately identify adenomyosis, enumerate and localize uterine fibroids, and provide more accurate identification of endometriosis and cystic teratomas of the ovary than US. Although MRI should not be used as a screening procedure for diagnosing endometrial or cervical carcinoma, it can aid in patient management by determining the extent of myometrial or cervical invasion by endometrial carcinoma and can be used to calculate tumor volume in patients with cervical carcinoma. Early studies suggest that MRI may be helpful in distinguishing between long-term radiation fibrosis and tumor recurrence in such patients. MRI findings may be highly indicative of the presence of ovarian malignancy, but the procedure adds little to CT or US findings. Nevertheless, MRI is superior in the localization of pelvic masses and is often indicated in clarifying the origin of a mass as uterine or ovarian.
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PMID:Applications of magnetic resonance imaging to gynecology. 218 59

We investigated the value of MRI in investigating uterine anatomy and disease. 1. Normal uterus: The signal intensity and endometrial thickness changed during the menstrual cycle. Endometrial thickness in the secretory phase was 12.8 +/- 3.6 mm, significantly greater than in the proliferative phase (5.4 +/- 0.7 mm, p less than 0.01). In contrast, endometrial thickness was reduced in postmenopausal women (4.1 +/- 0.9 mm) and was never over 6 mm. 2. Uterine disease: a. T2-weighted images were useful in differentiating leiomyoma and adenomyosis. Leiomyomas appeared as well-circumscribed nodules with sharp margins, while adenomyosis was seen as a low signal intensity area with an irregular border extending beneath the endometrium. b. In endometrial carcinoma, endometrial thickening with a high signal intensity was a characteristic of T2-weighted images, the maximal thickness being 16.5 +/- 6.9 mm. Moreover, endometrial carcinomas invading over 1/3 of the myometrium showed the following features: (1) The ratio of maximal endometrial thickness to uterine cross sectional diameter was over 50%. (2) The minimal myometrial thickness was under 5.0 mm. (3) The minimal to maximal myometrial thickness ratio was under 50%. Furthermore, cervical extension could be detected in all cases of endometrial carcinoma extending to the myometrium in T2-weighted images.
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PMID:[Clinical application of magnetic resonance imaging (MRI) in uterine disease]. 221 9

Gynecologic anatomy is consistently depicted with MRI. Abnormal developmental anatomy is also well assessed. In cases of complete or partial vaginal agenesis where ultrasound is equivocal, MRI can be definitive. The various subtypes of uterine anomalies are well delineated with MRI. MRI is the optimal technique in the therapeutic evaluation of leiomyomas, because the number, size, location, and degeneration can be documented. It is particularly useful in the identification of the ovaries in the presence of an enlarged leiomyomatous uterus. Adenomyosis, an often neglected diagnosis, is distinguishable from leiomyomas. In the setting of an equivocal ultrasound, MRI is useful in discerning whether a mass is ovarian or uterine in origin. Endometriosis, a disease routinely diagnosed and staged by laparoscopy, does have a typical MR appearance and therefore can usually be differentiated from other adnexal masses. Dermoids are readily diagnosed with MRI. Other adnexal masses do not have a specific MR appearance and morphologic criteria as used with ultrasound or CT must be relied upon in suggesting whether or not the mass is benign or malignant. MRI is the procedure of choice in the staging of cervical and endometrial cancer.
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PMID:Gynecologic applications of MRI. 228 64

MRI of 54 patients with endometrial and cervical carcinoma was performed on a 0.6-T superconducting magnet. In 18 of 24 cases of surgically proved endometrial carcinoma, MRI accurately showed the depth of myometrial invasion. MRI was superior to CT scan for defining the primary site and extent of the tumor in 14 of 24 cases. Of 25 patients with cervical carcinoma studied, MRI was superior to CT scan in 15 of 19 cases with CT correlation for localizing the primary site. MRI showed parametrial extension and invasion of surrounding structures but is probably less reliable than CT scan for detection of adenopathy because of false positive findings from volume averaging with bowel.
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PMID:MRI in staging of endometrial and cervical carcinoma. 358 83

We experienced a case of histological complete remission by preoperative intraarterial infusion chemotherapy in the treatment of histologically diagnosed endometrial cancer of well differentiated type. MRI demonstrated invasion of the myometrium to a depth of more than 1/2 and left partial parametrium. This patient was given intra-uterine arterial infusion chemotherapy twice (CDDP & ADM ia, CPA iv). Radical hysterectomy was done 3 weeks after intraarterial infusion chemotherapy. The extirpated uterus was histologically complete remission. Thus, in this case shows that intraarterial infusion chemotherapy is effective for neo-adjuvant chemotherapy of endometrial cancer.
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PMID:[A case of histological complete remission by preoperative intraarterial infusion chemotherapy]. 757 97

The Syed template (Alpha-Omega Services, Bellflower, CA) represents an advance in interstitial gynecologic brachytherapy; however, its appeal is diminished by inaccuracies in target definition secondary to suboptimal imaging of gynecologic tumors and the risk of viscus perforation during a "blind" procedure. Magnetic resonance (MR) scanning with an endorectal coil and computed tomography were studied as a possible tool to improve target definition and maximize treatment planning with Syed templates. Abdominopelvic contents could be visualized directly through a laparotomy incision or indirectly with a laparoscopic video display to allow further target definition and minimize complications associated with blind procedures after hysterectomy. The synthesis of these techniques with Syed template applications was attempted to potentiate the utility of this brachytherapy system. Five patients with apical vaginal tumors which arose after previous hysterectomies (two endometrial cancer recurrences, one recurrent uterine sarcoma, two primary vaginal cancers) were referred for radiotherapy. In three cases, external beam pelvic radiotherapy (median dose, 45 Gy; range, 45-50.4 Gy) was delivered initially. In all cases, the Syed applicator was used for the brachytherapy component of the treatment. In two cases, high-resolution MR images (400 x 400 microns) of the vaginal apex were obtained after insertion of an endorectal surface coil. The images defined the relationships between the template, target volume, bladder, rectum, and intestine. The other three cases were planned with computerized tomography (CT). In all cases, intraoperative examination of the abdominopelvic contents was provided when laparotomy and/or laparoscopy was performed by the surgical team. The median brachytherapy dose prescribed to the isodose envelope covering the target volume was 40 Gy (range, 31-50 Gy). In all cases, the target volumes could be encompassed by the 60 cGy/hr isodose line. Tumor volume estimation was better with MR than CT. Procedure time was shorter with laparoscopy than with laparotomy. In two cases, bowel displacement was performed (one tissue expander, one omental sling) to prevent viscus perforation by interstitial needles. Four of five patients responded completely to the treatment. In three cases, local control was maintained at a median follow-up of 11 months. In conclusion, endorectal coil MRI may be advantageous to CT of the pelvis in that it allows preplanning to be achieved with greater precision and with less planning time. Major intraoperative complications (i.e., perforation of hollow viscus organs) can be avoided when the course of interstitial catheters is visualized from above by the surgical team.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Improved treatment planning for the Syed-Neblett template using endorectal-coil magnetic resonance and intraoperative (laparotomy/laparoscopy) guidance: a new integrated technique for hysterectomized women with vaginal tumors. 789 94

Thirty-nine cases of endometrial carcinoma were analyzed by magnetic resonance imaging (0.15 or 1.5 tesla (T) MRI) prior to surgery to evaluate the depth of myometrial invasion of endometrial carcinoma. Several diagnostic parameters of MRI were set: maximum area of high-intensity area (HIA) in sagittal (HIASI) and transverse (HIATI) images of the uterus, minimum width of remaining myometrium (MWRM), and ratio of minimum to maximum width of normal myometrial thickness (RMMT). In analysis of correlation between myometrial invasion and MRI parameters, the correlation coefficient values of HIASI, HIATI, and MWRM were higher than those of other parameters at 0.71, 0.69, and -0.74, respectively. When cases were classified into three groups according to tumor invasion (tumor limited to endometrium, invasion to less than 50% of the myometrium, invasion to greater than 50% of the myometrium), MWRM was the most useful as a single parameter. Since HIASI and MWRM were independent parameters of myometrial invasion, they were selected for multivariate analysis. An equation to calculate the predicted depth of myometrial invasion was derived using both HIASI and MWRM by the multiple linear regression model. The equation could estimate the degree of myometrial invasion from the parameters of 1.5 T MRI. The values obtained from the equation are more useful for prediction of myometrial invasion of endometrial carcinoma than single parameters in both 0.15- and 1.5-T MRI.
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PMID:A multivariate analysis of assessment of myometrial invasion of endometrial carcinoma by magnetic resonance imaging. 808 6

It has been difficult to diagnose all but advanced cases of lymph node metastases with CT or MRI. It has been reported that the serum value of CA125 rises with the stage of endometrial cancer. This level is lower in the postmenopausal period than before menopause. In this study, we have examined the usefulness of CA125 for the assessment of lymph node metastasis in 43 postmenopausal endometrial cancer cases. There were significant differences in the CA125 level between lymph node metastasis positive cases and negative cases, between cancers occupying > or = 1/2 and < 1/2 of the uterine cavity, between lesions of > or = 1/3 and < 1/3 depth, and between surgical stages I, and III and IV. There was no significant correlation between serum CA125 levels and histological type. The serum CA125 value (mean +/- S.D., U/ml) was 179.0 +/- 291.0 (N = 6) in cases with lymph node metastasis and 15.8 +/- 8.5 (N = 37) in cases without metastasis (p < 0.001). We concluded that 32U/ml, which equals the mean + 2S.D., is a useful cut off value for suspicion of lymph node metastasis. The sensitivity and specificity of this cut off value were 100 (6/6) and 91.9% (34/37), respectively. This standard seems likely to considerably increase the accuracy of diagnosis of lymph node metastasis when taken in combination with the several factors already known to predict this. It may also be useful to diagnose lymph node metastasis in the preoperative period. Although the number of cases in this study was small, the data seem very promising for planning therapy for individual cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Usefulness of CA125 determination in the diagnosis of lymph node metastasis in post menopausal uterine endometrial carcinoma]. 815 Nov 75

Cervical carcinoma and endometrial carcinoma constitute the principal malignant tumors of the uterus. MRI has assumed an increasingly important role in the clinical staging of these neoplasms, and is particularly valuable for staging cervical carcinoma. The advantages of MRI as compared with computed tomography are superior soft tissue discrimination and multiplanar imaging capability. This review article outlines and illustrates the use of MRI for staging malignant uterine neoplasms and also considers post therapy follow-up of cervical carcinoma.
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PMID:Magnetic resonance evaluation of uterine malignancies. 817 40

Thirty-one patients clinically suspected for endometrial carcinomas were evaluated by MRI. MR imaging findings were compared with surgico-pathologic staging of the tumor following hysterectomy. The MR appearance of endometrial carcinoma included uterine enlargement, endometrial thickness greater than 1 cm, and nodular-massive pattern which was observed mainly on T2-weighted imaging. The tumor on T2-weighted image was of high homogeneous signal intensity and was indistinguishable from surrounding endometrium. When the junctional zone of endometrium-myometrium, so-called low signal zone, depicts segmental interruption or disappearance, it indicated that the tumor had invaded into the myometrium. If cervical canal was widened, with heterogeneous distribution of high signal intensity, cervical involvement by the tumor was demonstrated. According to criteria of MR staging of endometrial carcinoma proposed by Hricak, the accuracy of our results of MR staging was 87%. Therefore, we suggest that preoperative MR examination is useful for staging of endometrial carcinoma.
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PMID:[MRI staging of endometrial carcinoma]. 820 Feb 83


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