BackgroundTo obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer.MethodsDatabases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis.ResultsEleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05).ConclusionsCE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making.Key Points• CE-MRI is widely used for endometrial carcinoma• CE-MRI has a good performance in the prediction of any myometrial invasion• CE-MRI is superior to T2WI in the prediction of any myometrial invasion• For assessing deep myometrial involvement, its NPV appears relatively high