ABSTRACT
Background: Endometrial carcinoma is the fourth most common cancer in females and the most common malignancy of the female reproductive tract. The prognosis of endometrial carcinoma depends on a number of factors, including stage, depth of myometrial invasion, lympho-vascular invasion, nodal status and histologic grade. Preoperative assessment with MRI is essential for planning surgery and lymph node sampling. The objectives of this study were to determine the myometrial invasion of endometrial carcinoma by MRI and to obtain histopathology in surgically resected specimen, to compare the MRI findings of myometrial invasion in endometrial carcinoma with histopathology in respectable cases.Methods: Authors analyzed 41 cases in whom, histopathological diagnosis of carcinoma endometrium was established by means of pre-treatment biopsy. Consenting patients were taken up for preoperative MRI FIGO staging. MR images were reviewed for parameters like depth of myometrial invasion. Further surgical management followed by histopathological FIGO staging was done.Results: The study showed MRI was highly sensitive and specific tool for identifying depth of myometrial invasion, cervical invasion, serosal invasion, vaginal and parametrial invasion.Conclusions: There was statistically significant difference between histopathological and MRI assessment of local invasion of endometrial carcinoma.
ABSTRACT
Background: Characterizing adrenal lesions in patients with a known primary malignancy has a vital role in treatment and prognostication. A study by Gufler et al proposed a scoring system based on density, contour, homogeneity and size and found a high accuracy in differentiating adrenal adenomas from metastasis in patients with a known malignancy. This study evaluates the sensitivity and specificity of this NECT scoring system and comparing it with that of 18F FDG PET.Methods: The study was conducted on patients with diagnosed malignancies with adrenal mass, referred for 18F-FDG PET-CT scanning as a part of work up or follows up between October 2014 and March 2016. Whole-body CT and PET images were obtained using standard protocol. NECT scoring and quantitative analysis of FDG uptake in the adrenal lesions (SUVavg analysis) is done separately.Results: Of the 50 patients studied, 33 patients had benign adrenal lesions and the rest had metastatic lesions. Most common site of primary was lung. NECT score yielded a sensitivity of 88.2%, specificity of 100% and positive predictive value of 100%. SUVavg analysis yielded a 100% sensitivity, specificity and positive predictive value. Comparison of the predictive power of the two tests showed a z score of 2.5 and p value of 0.0124.Conclusions: 18-FDG PET can be considered as a gold standard for differentiating between metastasis and benign lesions of adrenal glands in patients with known primary. NECT has a comparable specificity as that of FDG PET, however with lower sensitivity.