Predictive value of T2-weighted imaging and dynamic contrast-enhanced MRI for assessing cervical invasion in patients with endometrial cancer: a meta-analysis

• Published in: Clinical imaging 2021-10, Vol.78, p.206-213
• Main Authors: Bi, Qiu, Chen, Yuhui, Chen, Jing, Zhang, Hongjiang, Lei, Yun, Yang, Jing, Zhang, Yan, Bi, Guoli
• Format: Article
• Language: English
• Subjects: Accuracy; Bias; Cancer; Cervical invasion; Cervix; Clinical trials; Diagnostic systems; Dynamic contrast-enhanced MRI; Endometrial cancer; Endometrium; Hysterectomy; Likelihood ratio; Magnetic resonance imaging; Medical imaging; Meta-analysis; Oophorectomy; Patients; Statistical analysis; T2-weighted imaging; Ultrasonic imaging
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2021.05.014

To obtain the diagnostic accuracy of T2-weighted imaging (T2WI), and dynamic contrast-enhanced MRI (DCE-MRI) in the preoperative assessment of cervical invasion in patients with endometrial cancer (EC). Databases including PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials were searched for relevant articles published from January 2000 to August 2020. Pooled estimation data were obtained by statistical analysis. In total, 24 articles were included. For assessing cervical invasion of EC, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for T2WI were 0.70 (0.61–0.77), 0.92 (0.89–0.94), 8.7 (6.5–11.6), 0.33 (0.25–0.43), 26 (17–41), and 0.92 (0.89–0.94), respectively. For DCE-MRI, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.75 (0.60–0.85), 0.95 (0.89–0.98), 14.7 (6.6–32.9), 0.27 (0.16–0.44), 55 (18–165), and 0.92 (0.89–0.94), respectively; for T2WI combined with DCE-MRI, they were 0.58 (0.41–0.73), 0.98 (0.95–0.99), 28.1 (12.8–62.1), 0.43 (0.30–0.63), 65 (29–146), and 0.94 (0.91–0.96), respectively. DCE-MRI demonstrated higher diagnostic performance than T2WI in the prediction of cervical invasion in patients with EC. T2WI combined with DCE-MRI improved the pooled specificity, PLR, DOR, and AUC compared to T2WI alone or DCE-MRI alone. •T2WI and DCE demonstrated high specificity for detecting cervical invasion of EC.•DCE had higher diagnostic performance than T2 for detecting cervical invasion of EC.•T2 + DCE showed higher specificity than T2 or DCE for detecting cervical invasion of EC.