Investigation of radiological pathological correlation of myometrial invasion in endometrial cancer

Objective: Endometrial cancer is the most common gynecological malignancy among women in developed countries, with the depth of myometrial invasion being a critical prognostic factor. This study aims to evaluate the concordance between magnetic resonance imaging (MRI) and pathological examination in patients with endometrial cancer, analyze the diagnostic accuracy of MRI in determining the depth of myometrial invasion, and assess its diagnostic performance. Methods: This retrospective study was conducted at the Department of Radiology, Faculty of Medicine, Çukurova University. A total of 165 patients diagnosed with endometrial cancer who underwent MRI and surgical procedures were included. Radiological and pathological findings were retrieved from hospital information systems and patient records. Statistical analyses were performed using SPSS version 25.0. Results: Moderate concordance was observed between MRI findings and pathological examination results (κ: 0.526; p<0.001). The diagnostic performance of MRI was evaluated, revealing an AUC of 78.2%, sensitivity of 67.5%, specificity of 88.9%, positive predictive value of 94.2%, and negative predictive value of 50.6%. MRI findings showed no pathological involvement in 47.9% of patients, less than 50% myometrial invasion in 28.5%, and more than 50% invasion in 23.6%. Conclusion: The results of this study indicate that MRI is a valuable adjunct in assessing the depth of myometrial invasion in endometrial cancer but emphasize that pathological examination should be considered the gold standard. The data highlights the high diagnostic accuracy of MRI and its significant role in clinical decision-making processes. Keywords: Endometrial cancer, myometrial invasion, magnetic resonance imaging