For a woman with apparently uterine-confined endometrial carcinoma, which imaging modality gives the most reliable preoperative assessment of depth of myometrial invasion?

• A Dynamic contrast enhanced magnetic resonance imaging ✓
• B Transvaginal ultrasound with colour Doppler
• C Computed tomography of abdomen and pelvis with contrast
• D FDG positron emission tomography combined with CT

Explanation

Dynamic contrast enhanced MRI, exploiting the enhancement difference between tumour and myometrium, is the accepted standard for assessing myometrial invasion depth, with accuracy around 85 to 90 percent when performed properly. Ultrasound is operator dependent and less accurate, CT cannot reliably delineate the junctional zone, and PET CT adds metabolic information useful in suspected nodal or metastatic disease rather than local invasion depth. MRI also assesses cervical stromal invasion for planning surgery.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.