caa a22 4500 605493286 CHVBK 20210128100520.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0399-7 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0399-7 Endometrial vs. cervical cancer: development and pilot testing of a magnetic resonance imaging (MRI) scoring system for predicting tumor origin of uterine carcinomas of indeterminate histology [Elektronische Daten] [Charis Bourgioti, Konstantinos Chatoupis, Evangelia Panourgias, Chara Tzavara, Kyrillos Sarris, Alexandros Rodolakis, Lia Moulopoulos] Purpose: To report discriminant MRI features between cervical and endometrial carcinomas and to design an MRI- scoring system, with the potential to predict the origin of uterine cancer (cervix or endometrium) in histologically indeterminate cases. Materials and methods: Dedicated pelvic MRIs of 77 patients with uterine tumors involving both cervix and corpus were retrospectively analyzed by two experts in female imaging. Seven MRI tumor characteristics were statistically tested for their discriminant ability for tumor origin compared to final histology: tumor location, perfusion pattern, rim enhancement, depth of myometrial invasion, cervical stromal integrity, intracavitary mass, and retained endometrial secretions. Kappa values were estimated to assess the levels of inter-rater reliability. On the basis of positive likelihood ratio values, an MRI-score was assigned. Results: K value was excellent for most of the imaging criteria. Using ROC curve analysis, the estimated optimal cut-off for the MRI-scoring system was 4 with 96.6% sensitivity and 100% specificity. Using a ≥4 cut-off for cervical cancers and <4 for endometrial cancers, 97.4% of the patients were correctly classified. 2/58 patients with cervical cancer had MRI score <4 and none of the patients with endometrial cancer had MRI score >4. The area under curve of the MRI-scoring system was 0.99 (95% CI 0.98-1.00). When the MRI-score was applied to 20/77 patients with indeterminate initial biopsy and to 5/26 surgically treated patients with erroneous pre-op histology, all cases were correctly classified. Conclusion: The produced MRI-scoring system may be a reliable problem-solving tool for the differential diagnosis of cervical vs. endometrial cancer in cases of equivocal histology. Springer Science+Business Media New York, 2015 Cervix uteri nationallicence Endometrium nationallicence Cancer nationallicence Magnetic resonance imaging nationallicence Immunohistochemistry nationallicence Bourgioti Charis Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut Chatoupis Konstantinos Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut Panourgias Evangelia Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut Tzavara Chara Department of Health, Epidemiology and Medical Statistics, Medical School, University of Athens, 25 Alexandroupoleos Str., 11527, Athens, Greece aut Sarris Kyrillos Radiation Oncology Department, Alexandra Hospital, 80 Vassilisis Sofias Ave, 11528, Athens, Greece aut Rodolakis Alexandros Gynecologic Oncology Unit, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, University of Athens, 80 Vassilisis Sofias Ave., 11528, Athens, Greece aut Moulopoulos Lia Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2529-2540 0942-8925 40:7<2529 2015 40 261 https://doi.org/10.1007/s00261-015-0399-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0399-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bourgioti Charis Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut NATIONALLICENCE 700 1- Chatoupis Konstantinos Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut NATIONALLICENCE 700 1- Panourgias Evangelia Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut NATIONALLICENCE 700 1- Tzavara Chara Department of Health, Epidemiology and Medical Statistics, Medical School, University of Athens, 25 Alexandroupoleos Str., 11527, Athens, Greece aut NATIONALLICENCE 700 1- Sarris Kyrillos Radiation Oncology Department, Alexandra Hospital, 80 Vassilisis Sofias Ave, 11528, Athens, Greece aut NATIONALLICENCE 700 1- Rodolakis Alexandros Gynecologic Oncology Unit, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, University of Athens, 80 Vassilisis Sofias Ave., 11528, Athens, Greece aut NATIONALLICENCE 700 1- Moulopoulos Lia Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, 76 Vassilisis Sofias Ave., 11528, Athens, Greece aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2529-2540 0942-8925 40:7<2529 2015 40 261