MRI-assessed tumor-free distance to serosa predicts deep myometrial invasion and poor outcome in endometrial cancer.

Autor: Dybvik JA; Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway. julie.andrea.dybvik@helse-bergen.no.; Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway. julie.andrea.dybvik@helse-bergen.no., Fasmer KE; Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.; Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway., Ytre-Hauge S; Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway., Husby JHA; Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway., Salvesen ØO; Unit for Applied Clinical Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Post Office Box 8905, 7491, Trondheim, Norway., Stefansson IM; Department of Pathology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.; Centre for Cancer Biomarkers, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway., Krakstad C; Department of Obstetrics and Gynaecology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Post Office Box 7804, 5020, Bergen, Norway., Trovik J; Department of Obstetrics and Gynaecology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Post Office Box 7804, 5020, Bergen, Norway., Haldorsen IS; Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.; Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway.
Jazyk: angličtina
Zdroj: Insights into imaging [Insights Imaging] 2022 Jan 08; Vol. 13 (1), pp. 1. Date of Electronic Publication: 2022 Jan 08.
DOI: 10.1186/s13244-021-01133-z
Abstrakt: Objectives: To explore the diagnostic accuracy of preoperative magnetic resonance imaging (MRI)-derived tumor measurements for the prediction of histopathological deep (≥ 50%) myometrial invasion (pDMI) and prognostication in endometrial cancer (EC).
Methods: Preoperative pelvic MRI of 357 included patients with histologically confirmed EC were read independently by three radiologists blinded to clinical information. The radiologists recorded imaging findings (T1 post-contrast sequence) suggesting deep (≥ 50%) myometrial invasion (iDMI) and measured anteroposterior tumor diameter (APD), depth of myometrial tumor invasion (DOI) and tumor-free distance to serosa (iTFD). Receiver operating characteristic (ROC) curves for the prediction of pDMI were plotted for the different MRI measurements. The predictive and prognostic value of the MRI measurements was analyzed using logistic regression and Cox proportional hazard model.
Results: iTFD yielded highest area under the ROC curve (AUC) for the prediction of pDMI with an AUC of 0.82, whereas DOI, APD and iDMI yielded AUCs of 0.74, 0.81 and 0.74, respectively. Multivariate analysis for predicting pDMI yielded highest predictive value of iTFD <  6 mm with OR of 5.8 (p < 0.001) and lower figures for DOI ≥ 5 mm (OR = 2.8, p = 0.01), APD ≥ 17 mm (OR = 2.8, p < 0.001) and iDMI (OR = 1.1, p = 0.82). Patients with iTFD < 6 mm also had significantly reduced progression-free survival with hazard ratio of 2.4 (p < 0.001).
Conclusion: For predicting pDMI, iTFD yielded best diagnostic performance and iTFD < 6 mm outperformed other cutoff-based imaging markers and conventional subjective assessment of deep myometrial invasion (iDMI) for diagnosing pDMI. Thus, iTFD at MRI represents a promising preoperative imaging biomarker that may aid in predicting pDMI and high-risk disease in EC.
(© 2021. The Author(s).)
Databáze: MEDLINE
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