フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Characteristics of MR Imaging for Staging and Survival Analysis of Neuroendocrine Carcinoma of the Endometrium: A Multicenter Study in Japan.
掲載誌名	正式名：Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine 略　 称：Magn Reson Med Sci ISSNコード：18802206/13473182
掲載区分	国外
巻・号・頁	20(3),pp.236-244
著者・共著者	Kazuhiro Kitajima, Takako Kihara, Yusuke Kawanaka, Junko Takahama, Yoshiko Ueno, Takamichi Murakami, Kotaro Yoshida, Fumi Kato, Akiko Takahata, Yoshihiko Fukukura, Jiro Munechika, Yasunari Fujinaga, Takeru Fukunaga, Masahiro Tanabe, Yuichiro Kanie, Ayumu Kido, Tsutomu Tamada, Rika Yoshida, Yuki Kamishima, Koichiro Yamakado
発行年月	2021/09
概要	PURPOSE:This study aimed to examine MRI features and staging of neuroendocrine carcinoma (NEC) of the endometrium and evaluate survival.METHODS:Clinical data, pathological, and preoperative pelvic MRI findings in 22 patients with histologically surgery-proven endometrial NEC were retrospectively reviewed. Tumors were pure NEC (n = 10) or mixed histotype (n = 12), with 13 large and nine small cell type.RESULTS:International Federation of Gynecology and Obstetrics (FIGO) staging was I, II, III, and IV in 6, 2, 12, and 2 patients, respectively. In 13 (76.4%) of 17 patients with pathological deep myometrial invasion, MRI showed abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with loss of normal uterine architecture. All tumors had restricted diffusion (apparent diffusion coefficient map low signal intensity, diffusion weighted imaging high signal intensity). Accuracy of T staging by MRI for all cases was 81.8%, with reference to pathology staging, while patient-based sensitivity, specificity, and accuracy for detecting metastatic pelvic lymph nodes was 60.0%, 100%, and 77.8%, respectively. Two intrapelvic peritoneal dissemination cases were detected by MRI. During follow-up (mean 30.4, range 3.3-138.4 months), 16 patients (72.7%) experienced recurrence and 12 (54.5%) died of disease. Two-year disease-free and overall survival rates for FIGO I, II, III, and IV were 66.7% and 83.3%, 50% and 100%, 10% and 33.3%, and 0% and 0%, respectively.CONCLUSION:Abnormal diffusely infiltrative high T2 signal intensity throughout the myometrium with normal uterine architecture loss and obvious restricted diffusion throughout the tumor are suggestive features of endometrial NEC. Pelvic MRI is reliable for intrapelvic staging of affected patients.
DOI	10.2463/mrms.mp.2020-0056
PMID	32713870