Role of x-ray CT in diagnosis and therapy of endometrial carcinoma

Since CT images after contrast enhancement (CE) delineate endometrial carcinoma as a low density area (LDA) in the uterus, carcinoma can be differentiated from normal myometrium in the image.FIn 21 patients with endometrial carcinoma, myometrial invasion was evaluated using three parameters, (1) the area occupied by LDA in the uterus, (2) the minimum thickness of the myometrium and (3) the maximum-minimum ratio of myometrial thickness, and the results were compared with findings on operation and on surgical specimens. CE increased the difference between the CT number of carcinoma and that of normal myometrium from 8.14 +- 3.90 HU (mean +- 1SD) to 26.20 +- 7.84 HU. The CT number of endometrial carcinoma before CE was 34.86 +- 8.42 HU, significantly lower than that of normal myometrium, 44.00 +- 6.94 HU (p<0.001), and the increase due to CE was 21.36 +- 6.49 HU, also significantly lower than that of normal myometrium, 41.62 +- 7.04 HU (p<0.001).FTo evaluate myometrial invasion, the extent of carcinoma in cases satisfyFing all three conditions, i.e., parameter (1) is 50% or less, parameter (2) is 0.5cm or more, and parameter (3) is 0.5 or more (Group A), was compared with that in cases not satisfying these conditions (Group B). The myometrial invasion of carcinoma exceeding 1/3 of the myometrial thickness was 0% in Group A and 100% in Group B. The lymphatic invasion of carcinoma was 11% in Group A and 70% in Group B. Metastasis was positive in 0% of Group A and 67% of Group B. (author)