How is endometrial cancer diagnosed, and what imaging features are considered in staging?
Endometrial cancer is diagnosed based on histopathology of a specimen from endometrial biopsy, curettage sample, or hysterectomy. Once the diagnosis is established, staging of endometrial cancer with imaging can be performed with PET or MRI, although surgical staging is still considered to be the reference standard. According to the International Federation of Gynecology and Obstetrics (FIGO), staging is based on features including myometrial invasion, cervical involvement, tumor extension into adjacent organs, lymph node involvement, and distant metastasis. Patients with greater than 50% myometrial invasion and cervical invasion are at high risk of recurrence and undergo pelvic lymphadenectomy at the time of tumor resection