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Evaluating the role of pre-operative MRI in atypical endometrial hyperplasia.
Poster Title: Evaluating the role of pre-operative MRI in atypical endometrial hyperplasia.
Submitted on 04 Nov 2020
Author(s): Noemi J Hughes, Hua Jiang, Maryse Sundaresan, Khalil Razvi, Sanjaya Kalkur, Jufen Zhang, Sidath Liyanage
Affiliations: Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Southend-on-Sea, SS0 0RY, United Kingdom. Anglia Ruskin University, East Road, Cambridge, Cambridgeshire, CB1 1PT.
This poster was presented at BIR Congress 2020
Poster Views: 59
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Poster Information
Abstract: The World Health Organisation classifies endometrial hyperplasia into the two categories of hyperplasia without atypia and atypical hyperplasia1. The most significant risk factor for progression to endometrial carcinoma is presence of cellular atypia2–4, however, the incidence of carcinoma beyond stage 1 in women with atypical hyperplasia on biopsy has been found to be as low as 2% following hysterectomy5. This raises the potential efficacy of conservative management in such women, who may therefore benefit from assessment of myometrial involvement with MRI prior to radical surgery6.
At present, the Royal College of Obstetricians and Gynaecologists do not recommend routine MRI of the pelvis in women with atypical hyperplasia7. We have found, however, correlations between final histological outcomes of hysterectomy specimens and several pre-operative MRI variables. More data is required to demonstrate whether quotients such as DWIq, 60CONq and 120CONq values can increase the accuracy with which MRI scans are staged. For now, we suggest MRI may have beneficial influence on the management in women with more severe histology on endometrial biopsy.
Summary: Our aim was to evaluate the role of pre-operative MRI in staging endometrial disease and so its potential to influence the management of women with atypical hyperplasia at our study centre.References: 1.Carcangiu, M. L., Kurman, R. J., Carcangiu, M. L. & Herrington, C. S. WHO Classification of Tumours of Female Reproductive Organs. (International Agency for Research on Cancer, 2014).
2.Kurman, R. J., Kaminski, P. F. & Norris, H. J. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer 56, 403–412 (1985).
3.Sherman, A. I. & Brown, S. The precursors of endometrial carcinoma. Am. J. Obstet. Gynecol. 135, 947–956 (1979).
4.Armstrong, A. J., Hurd, W. W., Elguero, S., Barker, N. M. & Zanotti, K. M. Diagnosis and Management of Endometrial Hyperplasia. J. Minim. Invasive Gynecol. 19, 562–571 (2012).
5.Gallos, I. D. et al. Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 207, 266.e1-266.e12 (2012).
6.Kadirogullari, P., Atalay, C. R., Ozdemir, O. & Sari, M. E. Preva
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