Characteristics of MR Imaging for Staging and Survival Analysis of Neuroendocrine Carcinoma of the Endometrium: A Multicenter Study in Japan
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- Kitajima Kazuhiro
- Department of Radiology, Hyogo College of Medicine
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- Kihara Takako
- Department of Surgical Pathology, Hyogo College of Medicine
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- Kawanaka Yusuke
- Department of Radiology, Hyogo College of Medicine
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- Takahama Junko
- Department of Radiology, Nara Medical University
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- Ueno Yoshiko
- Department of Radiology, Kobe University Graduate School of Medicine
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- Murakami Takamichi
- Department of Radiology, Kobe University Graduate School of Medicine
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- Yoshida Kotaro
- Department of Radiology, Graduate School of Medicine Science, Kanazawa University
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- Kato Fumi
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
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- Takahata Akiko
- Department of Radiology, Kyoto Prefectural University of Medicine
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- Fukukura Yoshihiko
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Munechika Jiro
- Department of Radiology, Showa University School of Medicine
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- Fujinaga Yasunari
- Department of Radiology, Shinshu University School of Medicine
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- Fukunaga Takeru
- Department of Pathophysiological and Therapeutic Sciences, Tottori University
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- Tanabe Masahiro
- Department of Radiology, Yamaguchi University Graduate School of Medicine
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- Kanie Yuichiro
- Department of Radiology, Japanese Red Cross Society Himeji Hospital
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- Kido Ayumu
- Department of Radiology, Kawasaki Medical School
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- Tamada Tsutomu
- Department of Radiology, Kawasaki Medical School
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- Yoshida Rika
- Department of Radiology, Faculty of Medicine, Shimane University
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- Kamishima Yuki
- Department of Radiology, Nagoya City West Medical Center
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- Yamakado Koichiro
- Department of Radiology, Hyogo College of Medicine
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説明
<p>Purpose: This study aimed to examine MRI features and staging of neuroendocrine carcinoma (NEC) of the endometrium and evaluate survival.</p><p>Methods: Clinical data, pathological, and preoperative pelvic MRI findings in 22 patients with histologically surgery-proven endometrial NEC were retrospectively reviewed. Tumors were pure NEC (n = 10) or mixed histotype (n = 12), with 13 large and nine small cell type.</p><p>Results: International Federation of Gynecology and Obstetrics (FIGO) staging was I, II, III, and IV in 6, 2, 12, and 2 patients, respectively. In 13 (76.4%) of 17 patients with pathological deep myometrial invasion, MRI showed abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with loss of normal uterine architecture. All tumors had restricted diffusion (apparent diffusion coefficient map low signal intensity, diffusion weighted imaging high signal intensity). Accuracy of T staging by MRI for all cases was 81.8%, with reference to pathology staging, while patient-based sensitivity, specificity, and accuracy for detecting metastatic pelvic lymph nodes was 60.0%, 100%, and 77.8%, respectively. Two intrapelvic peritoneal dissemination cases were detected by MRI. During follow-up (mean 30.4, range 3.3–138.4 months), 16 patients (72.7%) experienced recurrence and 12 (54.5%) died of disease. Two-year disease-free and overall survival rates for FIGO I, II, III, and IV were 66.7% and 83.3%, 50% and 100%, 10% and 33.3%, and 0% and 0%, respectively.</p><p>Conclusion: Abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with normal uterine architecture loss and obvious restricted diffusion throughout the tumor are suggestive features of endometrial NEC. Pelvic MRI is reliable for intrapelvic staging of affected patients.</p>
収録刊行物
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- Magnetic Resonance in Medical Sciences
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Magnetic Resonance in Medical Sciences 20 (3), 236-244, 2021
日本磁気共鳴医学会