Content area
Abstract
Objectives
To update the 2009 ESUR endometrial cancer guidelines and propose strategies to standardize image acquisition, interpretation and reporting for endometrial cancer staging with MRI.
Methods
The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to 81 questions regarding the details of patient preparation, MR imaging protocol, image interpretation and reporting were collected, analysed and classified as “RECOMMENDED” versus “NOT RECOMMENDED” (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts).
Results
Consensus regarding patient preparation, MR image acquisition, interpretation and reporting was determined using the RAND-UCLA Appropriateness Method. A tailored MR imaging protocol and a standardized report were recommended.
Conclusions
These consensus recommendations should be used as a guide for endometrial cancer staging with MRI.
Key points
• MRI is recommended for initial staging of endometrial cancer.
• MR imaging protocol should be tailored based on the risk of lymph node metastases.
• Myometrial invasion is best assessed using combined axial-oblique T2WI, DWI and contrast-enhanced imaging.
• The mnemonic “Clinical and MRI Critical TEAM” summarizes key elements of the standardized report.
Details
1 IRCM, Montpellier Cancer Research institute, Montpellier, France; Department of Radiology, Montpellier Cancer institute, INSERM, U1194, University of Montpellier, Montpellier, France; Service de Radiologie, Institut régional du Cancer de Montpellier, Montpellier, France
2 Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa Codex, Portugal
3 Department of Radiology Box 218, Cambridge Biomedical Campus Cambridge, Cambridge, UK
4 Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
5 UPMC Univ. Paris 06, Institut Universitaire de Cancérologie, Assistance Publique – Hôpitaux de Paris (AP-HP), Hôpital Tenon, Sorbonne Universités, Paris, France
6 Department of Diagnostic Radiology and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
7 Radiology Department, Sapienza University, Rome, Italy
8 Department of Radiology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
9 Departments of Radiology, Obstetrics and Gynecology, University of Wisconsin SMPH, Madison, WI, USA
10 Department of Radiology, Spital Bülach, Bülach, Switzerland
11 Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
12 Department of Radiology, Kantonsspital Baden, Baden, Switzerland
13 The Royal Marsden Hospital NHS Foundation Trust, London, UK; Imperial College, London, UK
14 Department of Radiology Müllner Hauptstr, Salzburg, Austria