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- Title
MR diffusion imaging for preoperative staging of myometrial invasion in patients with endometrial cancer: a systematic review and meta-analysis.
- Authors
Andreano, Anita; Rechichi, Gilda; Rebora, Paola; Sironi, Sandro; Valsecchi, Maria; Galimberti, Stefania
- Abstract
Objectives: To compare the diagnostic accuracy of dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MR imaging in detecting deep myometrial invasion in endometrial cancer, using surgical-pathological staging as reference standard. Methods: After searching a wide range of electronic databases and screening titles/abstracts, we obtained full papers for potentially eligible studies and evaluated according to predefined inclusion criteria. Quality assessment was conducted by adapting the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist. From each study, we extracted information on diagnostic performance of DW and DCE sequences. After exploring heterogeneity, we adopted a bivariate generalized linear mixed model to compare the effect of the two MR sequences jointly on sensitivity and specificity. Results: Nine studies (442 patients) were considered. Significant evidence of heterogeneity was found only for specificity, both in DW and DCE imaging ( I = 70.8 % and 70.6 %). Pooled sensitivity of DW and DCE was 0.86 and specificity did not significantly differ ( p = 0.16) between the two sequences (DW = 0.86 and DCE = 0.82). No difference was found between 3-T and 1.5-T MR. There was no evidence of publication bias. Conclusions: MR diagnostic accuracy in presurgical detection of deep myometrial infiltration in endometrial cancer is high. DCE and DW imaging do not differ in sensitivity and specificity. Key Points: • Myometrial invasion is the most important morphological prognostic feature of endometrial cancer • MR diagnostic accuracy in presurgical detection of deep myometrial infiltration is high • MR examination including T2 and DCE imaging is considered the reference standard • DW imaging has been increasingly employed with heterogeneous results • This meta-analysis shows that DCE and DW do not differ in diagnostic accuracy
- Subjects
ENDOMETRIAL cancer; MAGNETIC resonance imaging; MYOMETRIUM; DIAGNOSTIC imaging research; META-analysis
- Publication
European Radiology, 2014, Vol 24, Issue 6, p1327
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-014-3139-4