Validation of MRI short axis analysis for predicting lymphovascular invasion in endometrial cancer patients

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-21 DOI:10.1016/j.ejrad.2025.112259

Amelia Favier , Leo Razakamanantsoa , Julie Mereaux , Samia Lamrabet , Edwige Pottier , Claire Theodore , Cyril Touboul , Bassam Haddad , Yohann Dabi , Isabelle Thomassin-Naggara

{"title":"Validation of MRI short axis analysis for predicting lymphovascular invasion in endometrial cancer patients","authors":"Amelia Favier , Leo Razakamanantsoa , Julie Mereaux , Samia Lamrabet , Edwige Pottier , Claire Theodore , Cyril Touboul , Bassam Haddad , Yohann Dabi , Isabelle Thomassin-Naggara","doi":"10.1016/j.ejrad.2025.112259","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In the context of FIGO classification updates in Endometrial Cancer (EC), lymphovascular space invasion (LVSI) is often either missing or wrongly assessed in preoperative histological analysis.</div></div><div><h3>Objective</h3><div>This retrospective study aimed to validate the diagnostic efficacy of systematic short-axis measurement on preoperative MRI for predicting lymphovascular space invasion (LVSI) in patients with EC.</div></div><div><h3>Materials</h3><div>A total of 116 patients who underwent preoperative pelvic MRI between January 2015 and December 2019 were included. Two expert radiologists specializing in female pelvic MRI measured the tumor’s short axis (previously described by Lavaud et al) on all sequences in sagittal axes T2-weighted and post-contrast T1-weighted images fat suppressed. MRI findings were compared with preoperative biopsy results and postoperative histopathology.</div></div><div><h3>Results</h3><div>The analysis revealed the highest discrepancies between preoperative histology combined with MRI images and final pathology in tumor grade (21.6 %), FIGO stage (39.6 %), and myometrial invasion (27.6 %). A 24 mm threshold for the anteroposterior measurement was used as a predictor of LVSI. The model utilizing this cutoff demonstrated good performance (AUC = 0.61, p < 0.001) and correctly reclassified 19.8 % of patients with preoperative FIGO stage I tumors as FIGO stage II or more after surgery.</div></div><div><h3>Conclusion</h3><div>This approach may enhance the preoperative prediction of LVSI and improve the application of the updated FIGO classification in endometrial cancer. The results suggest that MRI-derived short-axis measurement could be a valuable tool for refining the preoperative assessment of LVSI in EC patients.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112259"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25003456","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

In the context of FIGO classification updates in Endometrial Cancer (EC), lymphovascular space invasion (LVSI) is often either missing or wrongly assessed in preoperative histological analysis.

Objective

This retrospective study aimed to validate the diagnostic efficacy of systematic short-axis measurement on preoperative MRI for predicting lymphovascular space invasion (LVSI) in patients with EC.

Materials

A total of 116 patients who underwent preoperative pelvic MRI between January 2015 and December 2019 were included. Two expert radiologists specializing in female pelvic MRI measured the tumor’s short axis (previously described by Lavaud et al) on all sequences in sagittal axes T2-weighted and post-contrast T1-weighted images fat suppressed. MRI findings were compared with preoperative biopsy results and postoperative histopathology.

Results

The analysis revealed the highest discrepancies between preoperative histology combined with MRI images and final pathology in tumor grade (21.6 %), FIGO stage (39.6 %), and myometrial invasion (27.6 %). A 24 mm threshold for the anteroposterior measurement was used as a predictor of LVSI. The model utilizing this cutoff demonstrated good performance (AUC = 0.61, p < 0.001) and correctly reclassified 19.8 % of patients with preoperative FIGO stage I tumors as FIGO stage II or more after surgery.

Conclusion

This approach may enhance the preoperative prediction of LVSI and improve the application of the updated FIGO classification in endometrial cancer. The results suggest that MRI-derived short-axis measurement could be a valuable tool for refining the preoperative assessment of LVSI in EC patients.

查看原文本刊更多论文

MRI短轴分析预测子宫内膜癌患者淋巴血管侵犯的有效性验证

在子宫内膜癌（EC） FIGO分类更新的背景下，在术前组织学分析中，淋巴血管间隙侵犯（LVSI）经常被遗漏或错误评估。目的通过回顾性研究，验证术前MRI系统短轴测量对EC患者淋巴血管间隙侵犯（LVSI）的诊断价值。在2015年1月至2019年12月期间，共纳入116例术前盆腔MRI患者。两名专门从事女性骨盆MRI的放射科专家在矢状轴t2加权和对比后t1加权图像的所有序列上测量了肿瘤的短轴（先前由Lavaud等人描述）。将MRI结果与术前活检结果和术后组织病理学结果进行比较。结果术前组织学结合MRI影像与最终病理差异最大的是肿瘤分级（21.6%）、FIGO分期（39.6%）和子宫肌层浸润（27.6%）。采用24 mm的正侧测量阈值作为LVSI的预测因子。利用该截止点的模型表现出良好的性能(AUC = 0.61, p <；0.001)，并且19.8%的术前FIGO I期肿瘤患者在手术后正确地重新分类为FIGO II期或以上。结论该方法可提高LVSI的术前预测，提高FIGO分级在子宫内膜癌中的应用。结果表明，mri衍生的短轴测量可能是一种有价值的工具，可用于改进EC患者LVSI的术前评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.