A dedicated MRI protocol is crucial for accurate MRI evaluation of endometrial carcinomas.
Imaging is optimally performed after 3 hours of fasting to reduce bowel peristalsis and following administration of an antiperistaltic agent unless contraindicated.
Supine position using a pelvic phased array multicoil 1.
- high resolution T2 weighted imaging in 3 orthogonal planes angled to the uterine cavity with further sequences angled to the cervix if cervical involvement is suspected
- slice thickness <4 mm
- FOV 25 cm
- high resolution matrix
T1 weighted imaging of retroperitoneum to detect nodal involvement
- axial or coronal
- extended field of view (FOV)
- dynamic gadolinium-enhanced T1-weighted imaging (small field of view): usually 2 planes (sagittal and axial oblique) or 3 planes to evaluate the extent of myometrial and cervical involvement 1,2
- optimal timing to detect myometrial invasion is approximately 2 minutes following contrast injection
- 1. Manfredi R, Gui B, Maresca G et-al. Endometrial cancer: magnetic resonance imaging. Abdom Imaging. 30 (5): 626-36. doi:10.1007/s00261-004-0298-9 - Pubmed citation
- 2. Sala E, Wakely S, Senior E et-al. MRI of malignant neoplasms of the uterine corpus and cervix. AJR Am J Roentgenol. 2007;188 (6): 1577-87. doi:10.2214/AJR.06.1196 - Pubmed citation
- 3. Ascher SM, Reinhold C. Imaging of cancer of the endometrium. Radiol. Clin. North Am. 2002;40 (3): 563-76. - Pubmed citation
- 4. Shibutani O, Joja I, Shiraiwa M et-al. Endometrial carcinoma: efficacy of thin-section oblique axial MR images for evaluating cervical invasion. Abdom Imaging. 24 (5): 520-6. Abdom Imaging (link) - Pubmed citation
- 5. K. Kinkel, R. Forstner, F. M. Danza, L. Oleaga, T. M. Cunha, A. Bergman, J. O. Barentsz, C. Balleyguier, B. Brkljacic, J. A. Spencer. Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging. (2009) European Radiology. 19 (7): 1565. doi:10.1007/s00330-009-1309-6 - Pubmed