Table 2 MRI protocol and assessment
From: Radiology–pathology correlation of endometrial carcinoma assessment on magnetic resonance imaging
Sequence | Plane (s) | Slice thickness | Tumour characteristics and what to look for |
|---|---|---|---|
T1W | Axial T1W | 5 mm | - Endometrial cancer is isointense to myometrium on T1W - Haematometros is often seen post-biopsy and hyperintense |
T2W | Sagittal T2W | 4 mm | - Endometrial carcinoma has an intermediate signal on T2W - Best sequences for anatomical delineation - Assess depth of myometrial invasion and local staging |
Axial T2W | 4 mm | ||
Oblique axial T2W | 3 mm | ||
DWI | Oblique axial DWI (b50, 500, 800) | 4 mm | - Endometrial carcinoma shows diffusion restriction - Assess depth of myometrial invasion - Detection of small tumour deposits in the cervix, adnexa, or vagina - Detection of lymph nodes—however, does not distinguish between malignant and benign nodes |
DCE and post-contrast T1W | Sagittal DCE T1W | 3 mm | - Tumour enhancement is homogeneous, slower and less avid compared to the myometrium - Early enhanced imaging helps in detecting junctional zone (subendometrial myometrium) to exclude myometrial invasion - Loss of the normal rim of enhancement of the outer myometrium indicates serosal involvement - Assess depth of myometrial invasion - Assess presence of cervical or vaginal invasion |
3D Axial T1W FS with oblique axial reformat | 1 mm |