Abstract
Objective:
To compare staging by MRI and histopathology in women with endometrial carcinoma

Methodology:
This was a retrospective study conducted in Fauji Foundation Hospital, Foundation University Islamabad from January 2018 till May 2022 which included 32 diagnosed cases of endometrial carcinoma. The primary outcome of the study was to assess the diagnostic value of MRI in preoperative staging and risk assessment in endometrial carcinoma when compared with the histopathological staging of the surgical specimen according to the FIGO 2021 staging system. The secondary outcome was to assess the role of both MRI and preoperative biopsy in preoperative risk assignment.

Results:
In this study MRI had a diagnostic accuracy of 78% for detection of stage I, 93% for stage II and 75% for stage III endometrial carcinoma. The sensitivity, specificity, NPV, PPV and diagnostic accuracy of MRI in detecting cervical invasion was 50%, 64.2%, 90%, 16.6% and 62.5% respectively. For myometrial invasion MRI was 78.1% accurate, 92.3% sensitive and 68.4%sensitive while NPV and PPV values were 92.8% and 66.6% respectively. For differentiating low risk and high risk groups, the sensitivity, specificity, NPV and PPV of MRI alone was 85.7%, 64.3%, 94.1%, 40% whereas when combined with preoperative biopsy the sensitivity and NPV was 100%.

Conclusion:
Although MRI is useful in preoperative staging and risk assessment of endometrial carcinoma but as the sensitivity and PPV for high risk group detection were low other modalities may need to be considered in adjunct for the decision of lymphadenectomy.