TY - JOUR
T1 - ACR Appropriateness Criteria® Pretreatment Evaluation and Follow-Up of Endometrial Cancer
AU - Expert Panel on GYN and OB Imaging
AU - Reinhold, Caroline
AU - Ueno, Yoshiko
AU - Akin, Esma A.
AU - Bhosale, Priyadarshani R.
AU - Dudiak, Kika M.
AU - Jhingran, Anuja
AU - Kang, Stella K.
AU - Kilcoyne, Aoife
AU - Lakhman, Yulia
AU - Nicola, Refky
AU - Pandharipande, Pari V.
AU - Paspulati, Rajmohan
AU - Shinagare, Atul B.
AU - Small, William
AU - Vargas, Hebert Alberto
AU - Whitcomb, Bradford P.
AU - Glanc, Phyllis
N1 - Publisher Copyright:
© 2020 American College of Radiology
PY - 2020/11
Y1 - 2020/11
N2 - To date, there is little consensus on the role of pelvic imaging in assessing local disease extent during initial staging in patients with endometrial carcinoma, with practices differing widely across centers. However, when pretreatment assessment of local tumor extent is indicated, MRI is the preferred imaging modality. Preoperative imaging of endometrial carcinoma can define the extent of disease and indicate the need for subspecialist referral in the presence of deep myometrial invasion, cervical extension, or suspected lymphadenopathy. If distant metastatic disease is clinically suspected, preoperative assessment with cross-sectional imaging or PET/CT may be performed. However, most patients with low-grade disease are at low risk of lymph node and distant metastases. Thus, this group may not require a routine pretreatment evaluation for distant metastases. Recurrence rates in patients with endometrial carcinoma are infrequent. Therefore, radiologic evaluation is typically used only to investigate suspicion of recurrent disease due to symptoms or physical examination and not for routine surveillance after treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - To date, there is little consensus on the role of pelvic imaging in assessing local disease extent during initial staging in patients with endometrial carcinoma, with practices differing widely across centers. However, when pretreatment assessment of local tumor extent is indicated, MRI is the preferred imaging modality. Preoperative imaging of endometrial carcinoma can define the extent of disease and indicate the need for subspecialist referral in the presence of deep myometrial invasion, cervical extension, or suspected lymphadenopathy. If distant metastatic disease is clinically suspected, preoperative assessment with cross-sectional imaging or PET/CT may be performed. However, most patients with low-grade disease are at low risk of lymph node and distant metastases. Thus, this group may not require a routine pretreatment evaluation for distant metastases. Recurrence rates in patients with endometrial carcinoma are infrequent. Therefore, radiologic evaluation is typically used only to investigate suspicion of recurrent disease due to symptoms or physical examination and not for routine surveillance after treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - AUC
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Endometrial carcinoma
KW - Imaging evaluation
KW - Recurrence
KW - Staging
KW - Surveillance
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U2 - 10.1016/j.jacr.2020.09.001
DO - 10.1016/j.jacr.2020.09.001
M3 - Article
C2 - 33153558
AN - SCOPUS:85093067053
SN - 1546-1440
VL - 17
SP - S472-S486
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 11
ER -