The following is a summary of “Evaluation of pre-therapeutic imaging work-up in the staging of endometrial cancer: Interest in a systematic second opinion in a cancer center,” published in the February 2024  issue of Obstetrics and Gynecology by Baijnath et al.

For a study, researchers sought to find out if getting a second opinion on quality rating and FIGO staging as part of the imaging work-up before treatment is helpful. They looked back at 156 people who had surgery at their hospital for endometrioid cancer and did a monitoring study. About 42% had their first MRI scans at University Hospital and Cancer Center, which are expert centers, while 58% had them at centers that were not expert centers. They looked at the quality rating, how well the first reports matched up, and second views from a junior and a senior ICL radiologist compared to tissue data.

MRI scans done in places with experts were more thorough and more likely to be ranked as better quality. In expert centers, T staging from initial reports was 0.59 (95% CI, 0.46–0.71) more accurate than the gold standard. In non-expert centers, it was 0.49 (95% CI, 0.38–0.60) more accurate. Overall, the second opinion for FIGO 2009 staging from an expert center was 0.61 (95% CI, 0.48–0.72) correct compared to 0.50 (95% CI, 0.39–0.60) correct and 0.37 vs 0.27 correct for the junior reader. It was 0.62 (95% CI, 0.49–0.74) correct compared to 0.48 (95% CI, 0.37–0.58) correct and 0.39 vs 0.24 correct for the senior reader. It was also found that the junior radiologist had less faith in MRI FIGO grading for exams done at non-expert centers (P 0.003).

The FIGO 2009 stage and quality rating are more accurate when MR exams are done from expert centers rather than non-expert centers. Before starting treatment, a joint meeting should include a second opinion from doctors in expert centers.

Source: sciencedirect.com/science/article/abs/pii/S2468784723001836