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The Ability of Helical CT to Preoperatively Stage Endometrial Carcinoma

Lara A. Hardesty1, Jules H. Sumkin1, Christiane Hakim1, Christopher Johns1 and Manju Nath2

1 Department of Radiology, Magee Women's Hospital, University of Pittsburgh, 300 Halket St., Pittsburgh, PA 15213.
2 Department of Pathology, Magee Women's Hospital, University of Pittsburgh, Pittsburgh, PA 15213.



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  		Fig. 1A. —58-year-old woman with endometrial carcinoma. Enhanced helical CT scan of markedly enlarged uterus shows enhancing myometrium peripherally and low-density tumor centrally, invading greater than 50% of myometrial thickness posteriorly. Hysterectomy confirmed invasion of greater than 95% of myometrial thickness.

 


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  		Fig. 2A. —70-year-old woman with endometrial carcinoma. Enhanced helical CT scan shows endometrial cavity distended with low-density tumor that invades greater than 50% of enhancing myometrial thickness in left fundal region. Hysterectomy confirmed invasion of greater than 90% of myometrial thickness.

 


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  		Fig. 3. —79-year-old woman with endometrial carcinoma. Enhanced helical CT scan shows irregularly marginated low-density tumor centrally in endometrial cavity (asterisk), judged by all three radiologists to be tumor invading greater than 50% of myometrial wall on left. Hysterectomy found tumor invading only 30% of myometrial thickness. No leiomyoma or other pathologic explanation for CT findings and subsequent CT overstaging was found.

 


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  		Fig. 1B. —58-year-old woman with endometrial carcinoma. Enhanced helical CT scan shows enlarged ill-defined cervix containing irregularly marginated low-density tumor centrally. Hysterectomy confirmed cervical invasion.

 


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  		Fig. 2B. —70-year-old woman with endometrial carcinoma. Enhanced helical CT scan of bulky uniformly low-density cervix (asterisk). All three radiologists incorrectly believed that cervix was invaded by tumor. At hysterectomy, cervix was unremarkable.

 

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