Hongzan Sun, Presenter: Nothing to Disclose

Jun Xin, Abstract Co-Author: Nothing to Disclose

Pengyuan Wang, Abstract Co-Author: Nothing to Disclose

Qiyong Guo MD, Abstract Co-Author: Nothing to Disclose

To evaluate the usefulness of hybrid PET/MR imaging in assessing preoperative staging of patients with endometrial carcinoma.

44 cases of endometrial carcinoma were examined by hybrid PET/MR before operation, including T2WI, DWI and FDG PET. Imaging information from T2WI, T2WI-DWI and T2WI-PET combined imaging, and overall imaging (T2WI-PET+DWI) was compared with pathological findings. Overall stage (according to 2009 FIGO staging) was defined after the consensus determination of two radiologists. Accuracy, sensitivity and specificity were analysed with the McNemar test; the areas under the receiver operating characteristic curve (Az) were compared with the Pairwise comparison.

12, 14, 8 and 10 cases were pathologically staged in IA, IB, II and III. The accuracy, sensitivity, specificity and Az for preoperative staging, respectively, were as follows: Stage IA- T2WI, 75%, 58%, 81% and 0.698; T2WI-DWI, 91%, 75%, 97% and 0.844; T2WI-PET, 80%, 58%, 88% and 0.760; T2WI-PET+DWI, 93%, 83%, 97% and 0.901. Besides lowest diagnostic efficacy in T2WI (P<0.05), significant difference was also found between T2WI-PET and T2WI-PET+DWI (P=0.0362). Stage IB- T2WI, 70%, 57%, 77% and 0.669; T2WI-DWI, 82%, 64%, 90% and 0.771; T2WI-PET, 80%, 71%, 86% and 0.774; T2WI-PET+DWI, 89%, 86%, 90% and 0.879. There was significant difference in diagnostic efficacy between T2WI and T2WI-DWI (P=0.0317) and between T2WI and T2WI-PET+DWI (P=0.0028). Stage II- T2WI, 76%, 50%, 81% and 0.667; T2WI-DWI, 86%, 75%, 89% and 0.819; T2WI-PET, 86%, 63%, 92% and 0.771; T2WI-PET+DWI, 91%, 75%, 94% and 0.847. Significant difference in diagnostic efficacy could only be found between T2WI and T2WI-PET+DWI (P=0.0358). Stage III- T2WI, 84%, 40%, 97% and 0.685; T2WI-DWI, 89%, 80%, 91% and 0.856; T2WI-PET, 93%, 80%, 97% and 0.885; T2WI-PET+DWI, 95%, 90%, 97% and 0.935. Only T2WI showed lowest diagnostic efficacy with significant difference compared to T2WI-DWI, T2WI-PET and T2WI-PET+DWI (P=0.0427, 0.0143 and 0.0027 respectively).

For preoperative staging of endometrial carcinoma during pelvic hybrid PET/MR imaging, T2WI-PET plus DWI provides superior diagnostic efficacy, and DWI is a useful supplementary sequence in defining early stage (like stage IA) of endometrial carcinoma.

Huge potentials of hybrid PET/MR imaging in gynecologic oncology are emerging in right now clinical radiology.  

Sun, H, Xin, J, Wang, P, Guo, Q, Assessment of PET/MR Imaging in Preoperative Staging of Endometrial Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016557.html