Stephanie Nougaret1,2,3, Mariana Horta4, Evis Sala5, Yulia Lakhman6, Isabelle Thomassin-Naggara7, Aki Kido8, Gabriele Masselli9, Nishat Bharwani10, Elizabeth Sadowski11, Andrea Ertmer12, Milagros Otero-Garcia13, Rahel A Kubik-Huch14, Teresa M Cunha4, Andrea Rockall15,16, Rosemarie Forstner17. 1. IRCM, Montpellier Cancer Research institute, 208 Ave des Apothicaires, 34295, Montpellier, France. stephanienougaret@free.fr. 2. Department of Radiology, Montpellier Cancer institute, INSERM, U1194, University of Montpellier, 208 Ave des Apothicaires, 34295, Montpellier, France. stephanienougaret@free.fr. 3. Service de Radiologie, Institut régional du Cancer de Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier, France. stephanienougaret@free.fr. 4. Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisboa Codex, Portugal. 5. Department of Radiology Box 218, Cambridge Biomedical Campus Cambridge, CB2 0QQ, Cambridge, UK. 6. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 7. UPMC Univ. Paris 06, Institut Universitaire de Cancérologie, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Tenon, Sorbonne Universités, Service de Radiologie, 54 avenue Gambetta, 75020, Paris, France. 8. Department of Diagnostic Radiology and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 9. Radiology Department, Sapienza University, Viale del Policlinico 155, 00161, Rome, Italy. 10. Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Department of Surgery and Cancer, Imperial College, London. 3rd Floor, Queen Elizabeth the Queen Mother Building, Praed St, London, W21NY, UK. 11. Departments of Radiology, Obstetrics and Gynecology, University of Wisconsin SMPH, Madison, WI, USA. 12. Department of Radiology, Spital Bülach, Spitalstrasse 24, CH-8180, Bülach, Switzerland. 13. Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain. 14. Department of Radiology, Kantonsspital Baden, Baden, Switzerland. 15. The Royal Marsden Hospital NHS Foundation Trust, London, UK. 16. Imperial College, London, UK. 17. Department of Radiology Müllner Hauptstr, 48 Universitätsklinikum Salzburg, PMU 5020, Salzburg, Austria.
Abstract
OBJECTIVES: To update the 2009 ESUR endometrial cancer guidelines and propose strategies to standardize image acquisition, interpretation and reporting for endometrial cancer staging with MRI. METHODS: The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to 81 questions regarding the details of patient preparation, MR imaging protocol, image interpretation and reporting were collected, analysed and classified as "RECOMMENDED" versus "NOT RECOMMENDED" (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts). RESULTS: Consensus regarding patient preparation, MR image acquisition, interpretation and reporting was determined using the RAND-UCLA Appropriateness Method. A tailored MR imaging protocol and a standardized report were recommended. CONCLUSIONS: These consensus recommendations should be used as a guide for endometrial cancer staging with MRI. KEY POINTS: • MRI is recommended for initial staging of endometrial cancer. • MR imaging protocol should be tailored based on the risk of lymph node metastases. • Myometrial invasion is best assessed using combined axial-oblique T2WI, DWI and contrast-enhanced imaging. • The mnemonic "Clinical and MRI Critical TEAM" summarizes key elements of the standardized report.
OBJECTIVES: To update the 2009 ESUR endometrial cancer guidelines and propose strategies to standardize image acquisition, interpretation and reporting for endometrial cancer staging with MRI. METHODS: The published evidence-based data and the opinion of experts were combined using the RAND-UCLA Appropriateness Method and formed the basis for these consensus guidelines. The responses of the experts to 81 questions regarding the details of patient preparation, MR imaging protocol, image interpretation and reporting were collected, analysed and classified as "RECOMMENDED" versus "NOT RECOMMENDED" (if at least 80% consensus among experts) or uncertain (if less than 80% consensus among experts). RESULTS: Consensus regarding patient preparation, MR image acquisition, interpretation and reporting was determined using the RAND-UCLA Appropriateness Method. A tailored MR imaging protocol and a standardized report were recommended. CONCLUSIONS: These consensus recommendations should be used as a guide for endometrial cancer staging with MRI. KEY POINTS: • MRI is recommended for initial staging of endometrial cancer. • MR imaging protocol should be tailored based on the risk of lymph node metastases. • Myometrial invasion is best assessed using combined axial-oblique T2WI, DWI and contrast-enhanced imaging. • The mnemonic "Clinical and MRI Critical TEAM" summarizes key elements of the standardized report.
Entities:
Keywords:
Diffusion; Endometrial cancer; Guideline; Magnetic resonance imaging; Uterus
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