What question did this study set out to answer?

Evaluate the diagnostic accuracy of preoperative contrast-enhanced MRI for detecting cervical stromal invasion in endometrial cancer.

April 19, 2026Open Access

Diagnostic Accuracy of Preoperative Magnetic Resonance Imaging for Detecting Cervical Stromal Invasion in Endometrial Cancer: A Prospective Observational Study

Q: What does this research mean for the field?

Preoperative contrast-enhanced MRI provides high diagnostic accuracy (96.77%) and excellent specificity (100%) for detecting cervical stromal invasion in patients with endometrial cancer. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Points

Evaluate the diagnostic accuracy of preoperative contrast-enhanced MRI for detecting cervical stromal invasion in endometrial cancer.
Conducted a prospective observational study at a tertiary care center.
Included 30 patients with confirmed stage I or II endometrial cancer.
Performed preoperative contrast-enhanced pelvic MRI and compared with histopathological results post-surgery.
Assessed diagnostic performance using sensitivity, specificity, PPV, NPV, and overall accuracy.
MRI identified cervical stromal invasion in 4 patients (13.3%), while histopathology noted it in 5 patients (16.7%).
MRI showed a sensitivity of 80% and specificity of 100%.
Positive predictive value of 100% and negative predictive value of 96.2%.
Overall diagnostic accuracy reached 96.77%, with a Youden’s J index of 0.8.

Abstract

Background Accurate preoperative assessment of endometrial cancer is essential for optimal surgical planning and prognostication. Cervical stromal invasion upstages the disease to stage II and often necessitates a more radical surgical approach. Magnetic resonance imaging (MRI) is considered the imaging modality of choice for local staging due to its superior soft-tissue contrast and multiplanar capability. Objective To evaluate the diagnostic accuracy of preoperative contrast-enhanced MRI in detecting cervical stromal invasion in patients with endometrial cancer, using postoperative histopathological examination as the reference standard. Methods This prospective observational study was conducted at a tertiary care center from June 2020 to October 2021. A total of 30 patients with histologically confirmed stage I or stage II endometrial carcinoma underwent preoperative contrast-enhanced pelvic MRI. MRI findings were compared with postoperative histopathological results. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and Youden’s J index. Results The mean age of the study population was 59 years, and most patients were postmenopausal with early-stage disease. Cervical stromal invasion was identified in 4 patients (13.3%) on MRI and in 5 patients (16.7%) on histopathological examination. MRI demonstrated a sensitivity of 80% and specificity of 100%, with a PPV of 100% and NPV of 96.2%. The overall diagnostic accuracy was 96.77%, and Youden’s J index was 0.8. Conclusion Preoperative contrast-enhanced MRI demonstrates high diagnostic accuracy and excellent specificity in detecting cervical stromal invasion in endometrial cancer. It is a reliable modality for preoperative staging and may aid in guiding surgical management. Further multicenter studies with larger sample sizes are required to validate these findings.

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