Distinguishing Between Primary Endometrial and Cervical Cancer Diagnosis Using MRI

Magnetic resonance imaging (MRI) can determine if a patient has endometrial versus cervical cancer even when a biopsy cannot make that differentiation, according to a new study.

Determining the primary site of a tumor helps determine appropriate cancer treatment. The study, which was presented during the American Roentgen Ray Society annual meeting on May 3, 2011, in Chicago (IL, USA), found that radiologists using MRI could correctly identify the primary site of cancer in 79% of cases (38/48 patients) when biopsy results are inconclusive.

Endometrial and cervical cancers are common cancers in women, said Heather He, MD, PhD, from MD Anderson Cancer Center (Houston, TX, USA), where the study was conducted under the direction of Dr. Iyer and Dr. Bhosale. "In about 3% of the cases, there is difficulty determining the primary cancer site," she added. "Knowing the primary cancer site means that we can give the patients the most appropriate therapy and save some patients from unnecessary surgery," Dr. He said.

Two radiologists read the images as part of the study--one with five years experience and one with 18. Their diagnoses matched most of the time, which means that the readers' experience did not have much of an impact on the study results, explained Dr. He. "MRI can be applied on a broader scope; you don't have to have someone on staff with extensive experience to be able to offer this imaging service," she said.

The study also studied various MR sequences to determine which one was the most useful in making a diagnosis. "We found that sagittal T2 FSE weighted sequences and 2D [two-dimensional] and 3D T1-weighted dynamic enhanced sequences are the most helpful," Dr. He said.

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