Current research status on evaluation of endometrial carcinoma by MRI

doi:10.3877/cma.j.issn.1673-5250.2020.03.002

Endometrial carcinoma (EC) is one of three most common gynecological malignant tumors in China, and its incidence is with ascending tendency in recent years. EC is a relatively inert and curable disease in early stage, while it is highly aggressive in late stage or recurrence. The accurate preoperative evaluation is an important examination strategy for treatment of EC. MRI as the most accurate imaging examination method for EC can distinguish its clinical stage of International Federation of Gynecology and Obstetrics (FIGO) and evaluate its prognosis. In recent years, except for routine MRI, the application of dynamic contrast enhanced MR imaging (DCE-MRI), diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and other new imaging methods in preoperative and prognostic evaluation of EC have become a hotspot in this field. This paper focuses on the latest research status of relationship between MRI findings of patients with EC and its clinical stage of FIGO, new MRI technologies in diagnosis and treatment of EC patients, and predictive values of MRI in EC patients with fertility preservation.

Key words: Endometrial neoplasms, Myometrium, Dynamic contrast enhanced MR imaging, Diffusion magnetic resonance imaging, Intravoxel incoherent motion, Tumor infiltration, Fertility, Female

表1 EC患者的FIGO临床分期与其术前MRI辅助检查结果比较

FIGO临床分期		组织病理学检查结果		术前MRI辅助检查结果
Ⅰ期		肿瘤局限于子宫体
	Ⅰ_A期		仅限于子宫内膜或DMI<1/2	肿瘤局限于子宫内膜或侵犯至结合带，DMI<1/2
	Ⅰ_B期		DMI≥1/2	DMI≥1/2，而且增强MRI检查时，肿瘤超出结合带外轮廓
Ⅱ期		肿瘤侵犯宫颈间质，但是未超出子宫		宫颈间质环T2低信号破坏，T1增强宫颈间质信号破坏
Ⅲ期		肿瘤局部或区域扩散
	Ⅲ_A期		肿瘤侵犯浆膜层和(或)附件	浆膜层连续性破坏，或周围腹膜/附件上出现结节影
	Ⅲ_B期		阴道和(或)宫旁受累	肿瘤扩散至阴道上段或宫旁
	Ⅲ_C期		盆腔和(或)腹主动脉旁淋巴结转移	盆腔淋巴结或腹主动脉旁淋巴结肿大
	Ⅲ_C1期		盆腔淋巴结呈阳性	盆腔淋巴结肿大(短径>8 mm)
	Ⅲ_C2期		腹主动脉旁淋巴结呈阳性，伴或不伴盆腔淋巴结呈阳性	腹主动脉旁淋巴结肿大(短径>10 mm)
Ⅳ期		肿瘤侵犯膀胱和(或)直肠，和(或)远处转移
	Ⅳ_A期		肿瘤侵犯膀胱和(或)直肠	肿瘤扩散至膀胱/直肠，T2膀胱/直肠壁低信号破坏
	Ⅳ_B期		远处转移，包括腹腔转移和(或)腹股沟淋巴结	腹腔内转移，包括腹膜内或腹膜外。远处转移(血行播散)至肺、骨或肝脏，远处淋巴结肿大

表1 EC患者的FIGO临床分期与其术前MRI辅助检查结果比较

FIGO临床分期		组织病理学检查结果		术前MRI辅助检查结果
Ⅰ期		肿瘤局限于子宫体
	Ⅰ_A期		仅限于子宫内膜或DMI<1/2	肿瘤局限于子宫内膜或侵犯至结合带，DMI<1/2
	Ⅰ_B期		DMI≥1/2	DMI≥1/2，而且增强MRI检查时，肿瘤超出结合带外轮廓
Ⅱ期		肿瘤侵犯宫颈间质，但是未超出子宫		宫颈间质环T2低信号破坏，T1增强宫颈间质信号破坏
Ⅲ期		肿瘤局部或区域扩散
	Ⅲ_A期		肿瘤侵犯浆膜层和(或)附件	浆膜层连续性破坏，或周围腹膜/附件上出现结节影
	Ⅲ_B期		阴道和(或)宫旁受累	肿瘤扩散至阴道上段或宫旁
	Ⅲ_C期		盆腔和(或)腹主动脉旁淋巴结转移	盆腔淋巴结或腹主动脉旁淋巴结肿大
	Ⅲ_C1期		盆腔淋巴结呈阳性	盆腔淋巴结肿大(短径>8 mm)
	Ⅲ_C2期		腹主动脉旁淋巴结呈阳性，伴或不伴盆腔淋巴结呈阳性	腹主动脉旁淋巴结肿大(短径>10 mm)
Ⅳ期		肿瘤侵犯膀胱和(或)直肠，和(或)远处转移
	Ⅳ_A期		肿瘤侵犯膀胱和(或)直肠	肿瘤扩散至膀胱/直肠，T2膀胱/直肠壁低信号破坏
	Ⅳ_B期		远处转移，包括腹腔转移和(或)腹股沟淋巴结	腹腔内转移，包括腹膜内或腹膜外。远处转移(血行播散)至肺、骨或肝脏，远处淋巴结肿大

[1]	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018[J]. CA Cancer J Clin, 2018, 68(1): 7-30. DOI: 10.3322/caac.21442.
[2]	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. DOI: 10.3322/caac.21338.
[3]	Bhatla N, Denny L. FIGO Cancer Report 2018[J]．Int J Gynaecol Obstet, 2018, 143(Suppl2): 2-3. DOI: 10.1002/ijgo.12608.
[4]	Lee JW, Dubinsky T, Andreotti R, et al. ACR appropriateness criteria^® pretreatment evaluation and follow-up of endometrial cancer of the uterus[J]. Ultrasound Q, 2011, 27(2): 139-145. DOI: 10.1097/RUQ.0b013e31821b6f73.
[5]	Christensen JW, Dueholm M, Hansen ES, et al. Assessment of myometrial invasion in endometrial cancer using three-dimensional ultrasound and magnetic resonance imaging[J]. Acta Obstet Gynecol Scand, 2016, 95(1): 55-64. DOI: 10.1111/aogs.12806.
[6]	Alcázar JL, Gastón B, Navarro B, et al. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and Meta-analysis[J]. J Gynecol Oncol, 2017, 28(6): e86. DOI: 10.3802/jgo.2017.28.e86.
[7]	陈天佑，强金伟. 子宫内膜癌的DWI和DCE-MRI研究进展[J]. 放射学实践，2015, 30(2): 183-185. DOI: 10.13609/j.cnki.1000-0313.2015.02.023.
[8]	Kara Bozkurt D, Bozkurt M, Nazli MA, et al. Diffusion-weighted and diffusion-tensor imaging of normal and diseased uterus[J]. World J Radiol, 2015, 7(7): 149-156. DOI: 10.4329/wjr.v7.i7.149.
[9]	He Y, Ding N, Li Y, et al. 3-T diffusion tensor imaging (DTI) of normal uterus in young and middle-aged females during the menstrual cycle: evaluation of the cyclic changes of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values [J]. Br J Radiol, 2015, 88(1049): 20150043. DOI: 10.1259/bjr.20150043.
[10]	Kido A, Togashi K. Uterine anatomy and function on cine magnetic resonance imaging[J]. Reprod Med Biol, 2016, 15(4): 191-199. DOI: 10.1007/s12522-016-0235-y.
[11]	Hameeduddin A, Sahdev A. Diffusion-weighted imaging and dynamic contrast-enhanced MRI in assessing response and recurrent disease in gynaecological malignancies[J]. Cancer Imaging, 2015, 15(1): 1-12. DOI: 10.1186/s40644-015-0037-1.
[12]	Gordon Y, Partovi S, Müller-Eschner M, et al. Dynamic contrast-enhanced magnetic resonance imaging: fundamentals and application to the evaluation of the peripheral perfusion[J]. Cardiovasc Diagn Ther, 2014, 4(2): 147-164. DOI: 10.3978/j.issn.2223-3652.2014.03.01.
[13]	Jahng GH, Li KL, Østergaard L, et al. Perfusion magnetic resonance imaging: a comprehensive update on principles and techniques[J]. Korean J Radiol, 2014, 15(5): 554-577. DOI: 10.3348/kjr.2014.15.5.554.
[14]	Khalifa F, Soliman A, El-Baz A, et al. Models and methods for analyzing DCE-MRI: a review [J]. Med Phys, 2014, 41(12): 124301. DOI: 10.1118/1.4898202.
[15]	Türkbey B, Thomasson D, Pang Y, et al.The role of dynamic contrast-enhanced MRI in cancer diagnosis and treatment[J]．Diagn Interv Radiol, 2010, 16(3): 186-192. DOI: 10.4261/1305-3825.DIR.2537-08.1.
[16]	Winfield JM, Payne GS, Weller A, et al. DCE-MRI, DW-MRI, and MRS in cancer: challenges and advantages of implementing qualitative and quantitative multi-parametric imaging in the clinic [J]．Top Magn Reson Imaging, 2016, 25(5): 245-254. DOI: 10.1097/RMR.0000000000000103.
[17]	Kim H, Arnoletti PJ, Christein J, et al. Pancreatic adenocarcinoma: a pilot study of quantitative perfusion and diffusion-weighted breath-hold magnetic resonance imaging [J]. Abdom Imaging, 2014, 39(4): 744-752. DOI: 10.1007/s00261-014-0107-z.
[18]	Drisis S, Metens T, Ignatiadis M, et al. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy[J]. Eur Radiol, 2016, 26(5): 1474-1484. DOI: 10.1007/s00330-015-3948-0.
[19]	Koh TS, Bisdas S, Koh DM, et al. Fundamentals of tracer kinetics for dynamic contrast-enhanced MRI[J]. J Magn Reson Imaging, 2011, 34(6): 1262-1276. DOI: 10.1002/jmri.22795.
[20]	Tofts PS, Brix G, Buckley DL, et al. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols[J]. J Magn Reson Imaging, 1999, 10(3): 223-232. DOI: 10.1002/(sici)1522-2586(199909)10:3<223::aid-jmri2>3.0.co;2-s.
[21]	Larsson HB, Fritz-Hansen T, Rostrup E, et al. Myocardial perfusion modeling using MRI[J]. Magn Reson Med, 1996, 35(5): 716-726. DOI: 10.1002/mrm.1910350513.
[22]	Brix G, Bahner ML, Hoffmann U, et al. Regional blood flow, capillary permeability, and compartmental volumes: measurement with dynamic CT-initial experience[J]. Radiology, 1999, 210(1): 269-276. DOI: 10.1148/radiology.210.1.r99ja46269.
[23]	St Lawrence KS, Lee TY. An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: Ⅱ. Experimental validation[J]．Exp Validat J Cereb Blood Flow Metab, 1998, 18(12): 1378-1385. DOI: 10.1097/00004647-199812000-00012.
[24]	Koh TS, Thng CH, Lee PS, et al. Hepatic metastases: in vivo assessment of perfusion parameters at dynamic contrast-enhanced MR imaging with dual-input two-compartment tracer kinetics model[J]. Radiology, 2008, 249(1): 307-320. DOI: 10.1148/radiol.2483071958.
[25]	Baliyan V, Das CJ, Sharma R, et al. Diffusion weighted imaging: technique and applications[J]. World J Radiol, 2016，8(9): 785-798. DOI: 10.4329/wjr.v8.i9.785.
[26]	Buchbinder BR. Functional magnetic resonance imaging[J]．Handb Clin Neurol, 2016, 135: 61-92. DOI: 10.1016/B978-0-444-53485-9.00004-0.
[27]	Jensen JH, Helpern JA. MRI Quantification of non-Gaussian water diffusion by kurtosis analysis[J]. NMR Biomed, 2010，23(7): 698-710.DOI: 10.1002/nbm.1518.
[28]	Le Bihan D．What can we see with IVIM MRI? [J]．Neuroimage, 2019, 187(1): 56-67. DOI: 10.1016/j.neuroimage.2017.12.062.
[29]	Truong TK, Song AW. Cortical depth dependence and implications on the neuronal specificity of the functional apparent diffusion coefficient contrast[J]. Neuroimage, 2009, 47(1): 65-68. DOI: 10.1016/j.neuroimage.2009.04.045.
[30]	Fujima N, Yoshida D, Sakashita T, et al. Intravoxel incoherent motion diffusion-weighted imaging in head and neck squamous cell carcinoma: assessment of perfusion-related parameters compared to dynamic contrast-enhanced MRI[J]. Magn Reson Imag，2014, 32(10): 1206-1213. DOI: 10.1016/j.mri.2014.08.009.
[31]	Iima M, Kataoka M, Kanao S, et al.Intravoxel incoherent motion and quantitative non-gaussian diffusion MR imaging: evaluation of the diagnostic and prognostic value of several markers of malignant and benign breast lesions[J]. Radiology，2018，287(2): 432-441. DOI: 10.1148/radiol.2017162853.
[32]	Wissing M, Mitric C, Amajoud Z, et al. Risk factors for lymph nodes involvement in obese women with endometrial carcinomas [J]. Gynecol Oncol, 2019, 155(1): 27-33. DOI: 10.1016/j.ygyno.2019.07.016.
[33]	Nougaret S, Horta M, Sala E, et al. Endometrial cancer MRI staging: updated Guidelines of the European Society of Urogenital Radiology[J]. Eur Radiol, 2019, 29(2): 792-805. DOI: 10.1007/s00330-018-5515-y.
[34]	Zheng L, Zheng S, Yuan X, et al. Comparison of dynamic contrast-enhanced magnetic resonance imaging with T2-weighted imaging for preoperative staging of early endometrial carcinoma[J]. Onco Targets Ther, 2015, 8: 1743-1751. DOI: 10.2147/OTT.S86519.
[35]	Carneiro MM, Lamaita RM, Ferreira MC, et al. Fertility-preservation in endometrial cancer: is it safe? Review of the literature[J]. JBRA Assist Reprod, 2016, 20(4): 232-239. DOI: 10.5935/1518-0557.20160045.
[36]	Zhu L, Wang H, Zhu L, et al. Predictive and prognostic value of intravoxel incoherent motion (IVIM) MR imaging in patients with advanced cervical cancers undergoing concurrent chemo-radiotherapy[J]. Sci Rep, 2017, 7(1): 11635. DOI: 10.1038/s41598-017-11988-2.
[37]	Haldorsen IS, Gruner R, Husby JA, et al. Dynamic contrast-enhanced MRI in endometrial carcinoma identifies patients at increased risk of recurrence[J]. Eur Radiol, 2013, 23(10): 2916-2925. DOI: 10.1007/s00330-013-2901-3.
[38]	Beddy P, O′Neill AC, Yamamoto AK, et al. FIGO staging system for endometrial cancer: added benefits of MR imaging [J]. Radiographics, 2012, 32(1): 241-254. DOI: 10.1148/rg.321115045.
[39]	Andreano A, Rechichi G, Rebora P, et al. MR diffusion imaging for preoperative staging of myometrial invasion in patients with endometrial cancer: a systematic review and Meta-analysis[J]. Eur Radiol，2014, 24(6): 1327-1338. DOI: 10.1007/s00330-014-3139-4.
[40]	Bakir B, Sanli S, Bakir VL, et al. Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening[J]. Clin Imaging, 2017, 41(1): 86-94. DOI: 10.1016/j.clinimag.2016.10.016.
[41]	Jiang JX, Zhao JL, Zhang Q, et al. Endometrial carcinoma: diffusion-weighted imaging diagnostic accuracy and correlation with Ki-67 expression[J]. Clin Radiol, 2018, 73(4): 413.e1-e413.e6. DOI: 10.1016/j.crad.2017.11.011.
[42]	Sala E, Rockall A, Rangarajan D，et al. The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis[J]. Eur J Radiol, 2010, 76(3): 367-385. DOI: 10.1016/j.ejrad.2010.01.026.
[43]	Kinkel K, Forstner R, Danza FM, et al. Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Radiology[J]. Eur Radiol, 2009, 19(7): 1565-1574. DOI: 10.1007/s00330-009-1309-6.
[44]	Meissnitzer M, Forstner R. MRI of endometrium cancer - how we do it[J]. Cancer Imaging, 2016, 16: 11. DOI: 10.1186/s40644-016-0069-1.
[45]	Sala E, Wakely S, Senior E, et al. MRI of malignant neoplasms of the uterine corpus and cervix [J]. AJR Am J Roentgenol, 2007, 188(6): 1577-1587. DOI: 10.2214/AJR.06.1196.
[46]	Morice P, Leary A, Creutzberg C, et al. Endometrial cancer [J]. Lancet, 2016, 387(10023): 1094-1108. DOI: 10.1016/S0140-6736(15)00130-0.
[47]	Sourbrons SP, Buckley DL. Classic models for dynamic contrast-enhanced MRI [J]. NMR Biomed, 2013, 26(8): 1004-1027. DOI: 10.1002/nbm.2940.
[48]	Fukunaga T, Fujii S, Inoue C, et al. Accuracy of semiquantitative dynamic contrast-enhanced MRI for differentiating type Ⅱ from type Ⅰ endometrial carcinoma[J]. J Magn Reson Imaging, 2015, 41(6): 1662-1668. DOI: 10.1002/jmri.24730.
[49]	Todo Y, Kato H, Kaneuchi M, et al. Survival effect of paraaortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis [J]. Lancet, 2010, 375(9721): 1165-1172. DOI: 10.1016/S0140-6736(09)62002-X.
[50]	Ippolito D, Cadonici A, Bonaffini PA, et al. Semiquantitative perfusion combined with diffusion-weighted MR imaging in preoperative evaluation of endometrial carcinoma: results in a group of 57 patients [J]. Magn Reson Imaging, 2014, 32(5): 464-472. DOI: 10.1016/j.mri.2014.01.009.
[51]	Ippolito D, Minutolo O, Cadonici A, et al. Endometrial cancer: diagnostic value of quantitative measurements of microvascular changes with DCE-MR imaging [J]. MAGMA, 2014, 27(6): 531-538. DOI: 10.1007/s10334-014-0435-6.
[52]	Haldorsen IS, Stefansson I, Gruner R, et al. Increased microvascular proliferation is negatively correlated to tumour blood flow and is associated with unfavourable outcome in endometrial carcinomas [J]. Br J Cancer, 2014, 110(1): 107-114. DOI: 10.1038/bjc.2013.694.
[53]	Fasmer KE, Bjørnerud A, Ytre-Hauge S, et al. Preoperative quantitative dynamic contrast-enhanced MRI and diffusion-weighted imaging predict aggressive disease in endometrial cancer [J]. Acta Radiol, 2018, 59(8): 1010-1017. DOI: 10.1177/0284185117740932.
[54]	Kitajima K, Yamasaki E, Kaji Y, et al. Comparison of DWI and PET/CT in evaluation of lymph node metastasis in uterine cancer [J]. World J Radiol, 2012, 4(5): 207-214. DOI: 10.4329/wjr.v4.i5.207.
[55]	Gil RT, Cunha TM, Horta M, et al. The added value of diffusion-weighted imaging in the preoperative assessment of endometrial cancer [J]. Radiol Bras, 2019, 52(4): 229-236. DOI: 10.1590/0100-3984.2018.0054.
[56]	Gallego JC, Porta A, Pardo MC, et al. Evaluation of myometrial invasion in endometrial cancer: comparison of diffusion-weighted magnetic resonance and intraoperative frozen sections [J]. Abdom Imaging, 2014, 39(5): 1021-1026. DOI: 10.1007/s00261-014-0134-9.
[57]	Das SK, Niu XK, Wang JL, et al. Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and Meta-analysis [J]. Cancer Imaging, 2014, 14(1): 32. DOI: 10.1186/s40644-014-0032-y.
[58]	Liu J, Wan Y, Wang Z, et al. Perfusion and diffusion characteristics of endometrial malignancy based on intravoxel incoherent motion MRI at 3.0 T: comparison with normal endometrium [J]. Acta Radiol, 2016, 57(9): 1140-1148. DOI: 10.1177/0284185115618550.
[59]	Lee HJ, Rha SY, Chung YE, et al. Tumor perfusion-related parameter of diffusion-weighted magnetic resonance imaging: correlation with histological microvessel density [J]. Magn Reson Med, 2014, 71(4): 1554-1558. DOI: 10.1002/mrm.24810.
[60]	Bhosale P, Ramalingam P, Ma J, et al. Can reduced field-of-view diffusion sequence help assess microsatellite instability in FIGO stage 1 endometrial cancer? [J]. J Magn Reson Imaging, 2017, 45(4): 1216-1224. DOI: 10.1002/jmri.25427.
[61]	Fujimoto K, Kido A, Okada T, et al. Diffusion tensor imaging (DTI) of the normal human uterus in vivo at 3 tesla: comparison of DTI parameters in the different uterine layers [J]. J Magn Reson Imaging, 2013, 38(6): 1494-1500. DOI: 10.1002/jmri.24114.
[62]	Ueno Y, Forghani B, Forghani R，et al. Endometrial carcinoma: MR imaging-based texture model for preoperative risk stratification-A preliminary analysis[J]. Radiology, 2017, 284(3): 748-757. DOI: 10.1148/radiol.2017161950.
[63]	Uharcek P. Prognostic factors in endometrial carcinoma [J]. J Obstet Gynaecol Res, 2008, 34(5): 776-783. DOI: 10.1111/j.1447-0756.2008.00796.x.
[64]	Mazzon I, Corrado G, Masciullo V, et al. Conservative surgical management of stage Ⅰ_A endometrial carcinoma for fertility preservation [J]. Fertil Steril, 2010, 93(4): 1286-1289. DOI: 10.1016/j.fertnstert.2008.12.009.
[65]	丁雪梅，郑莹. 左炔诺孕酮宫内节育系统治疗要求保留生育功能的年轻子宫内膜癌的研究进展[J/CD]. 中华妇幼临床医学杂志(电子版), 2016, 12(2): 241-244. DOI: 10.3877/cma.j.issn.1673-5250.2016.02.021.
[66]	Wu LM, Xu JR, Gu HY, et al. Predictive value of T2-weighted imaging and contrast-enhanced MR imaging in assessing myometrial invasion in endometrial cancer: a pooled analysis of prospective studies [J]. Eur Radiol, 2013, 23(2): 435-449. DOI: 10.1007/s00330-012-2609-9.

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