Akademik Veri Yönetim Sistemi
Indian Journal of Gynecologic Oncology, cilt.24, sa.1, 2026 (ESCI, Scopus)
Background: Magnetic resonance imaging (MRI) enables physicians to examine the precise features of the body’s interior architecture. Aims: Our primary goal was to conduct a systematic review and meta-analysis to evaluate the diagnostic accuracy of advanced MRI techniques, including DCE-MRI and DW-MRI, specifically for assessing myometrial invasion, cervical invasion, and lymph node involvement in patients with biopsy-proven endometrial cancer. By examining the strengths and limitations of various medical imaging modalities, we aimed to clarify their role in improving preoperative staging and guiding surgical and therapeutic planning. Methods: We conducted a thorough and methodical search across six principal indexing databases utilizing keywords such as (“MRI“[Title/Abstract] OR “magnetic resonance imaging“[Title/Abstract] OR (“diffusion-weighted MRI“[Title/Abstract] AND “dynamic contrast-enhanced MRI“[Title/Abstract])) AND (“endometrial lesion*“[Title/Abstract] OR “endometrial cancer“[Title/Abstract]), which are crucial in identifying relevant studies. Moreover, we used (“diagnostic test accuracy“[Title/Abstract] OR “diagnostic value“[Title/Abstract] OR “Sensitivity“[Title/Abstract] OR “specificity“[Title/Abstract]), along with all conceivable combinations, to ensure a comprehensive search. This process helped us identify the most pertinent published articles from January 1990 to January 2025. Results: 18 studies (26 estimations) with 1001 patients were included. For the combined assessment of myometrial invasion, cervical invasion, and lymph node metastases, the pooled sensitivity of advanced MRI was 89% (95% CI: 86%-90%), and the specificity was 79% (95% CI: 75%-83%). Subgroup analysis indicated DW-MRI had higher sensitivity (89% vs. 85%), while DCE-MRI had higher specificity (82% vs. 78%). For myometrial invasion alone, sensitivity was 86% and specificity was 75%. For cervical invasion, sensitivity was 67% and specificity was 83%. For lymph node metastases, sensitivity was 69% and specificity was 88%. The area under the summary ROC curve was 0.8943. Conclusions: This meta-analysis offers strong, clinically relevant evidence that DWI-MRI and DCE-MRI are essential for preoperative staging of endometrial cancer. Their unique performance characteristics support the adoption of a standardized multiparametric MRI (mpMRI) protocol in clinical settings. DW-MRI should serve as a highly sensitive screening.