Pretreatment Evaluation & Followup of Endometrial Cancer

Endometrial carcinoma (EC) occurs when cancer cells form in the inner lining of the uterus, the endometrium. Imaging tests are used to develop treatment plans and monitor disease following treatment.

MRI pelvis with and without contrast is usually appropriate for initial staging. Ultrasound (US) pelvis transvaginal, CT pelvis with contrast, and MRI pelvis without contrast may also be appropriate.

For pretreatment evaluation of low-grade tumors, US pelvis transabdominal, MRI abdomen pelvis with and without contrast, MRI pelvis without contrast, CT chest abdomen pelvis with contrast, and PET/CT skull base to mid-thigh may be appropriate.

For evaluation of high-grade tumors, MRI pelvis with and without contrast, CT chest abdomen pelvis with contrast, PET/CT, or MRI pelvis with and without contrast is usually appropriate. US abdomen, US pelvis, MRI abdomen with and without contrast, MRI abdomen pelvis without contrast, and CT chest abdomen pelvis without intravenous contrast may be appropriate.

Imaging tests are not usually appropriate for follow-up of asymptomatic individuals with treated low- or intermediate-risk EC.

For follow-up of asymptomatic individuals with treated high-risk EC, x-ray chest, CT chest abdomen pelvis with contrast, and CT chest abdomen pelvis without contrast may be appropriate.

For individuals with clinically suspected recurrence of EC after treatment, MRI abdomen pelvis with and without contrast, CT chest abdomen pelvis with contrast, and PET/CT are usually appropriate. US abdomen, x-ray chest, MRI abdomen pelvis without contrast, and CT chest abdomen pelvis may also be appropriate.

For more information, visit the Endometrial Cancer page.

— By Selin Ege Yalcindag, BS and Sharon L. D’Souza, MD, MPH. This information originally appeared in the Journal of the American College of Radiology.