Depth of myometrial invasion in endometrial cancer: preoperative assessment by transvaginal ultrasonography and magnetic resonance imaging

Abstract

Depth of myometrial invasion in endometrial cancer correlates with pelvic lymph node metastases and tumor recurrence. Thirty patients diagnosed as having FIGO stage I endometrial carcinoma on the basis of D&C were evaluated preoperatively by magnetic resonance imaging (MRI); 14 cases of the same group were also evaluated by transvaginal ultrasound. The degree of invasion evaluated by MRI and transvaginal sonography was compared to the pathological specimens. MRI was successful in evaluating myometrial invasion in 2.5 of 30 cases (accuracy 83%, sensitivity 87%, specificity 78%, positive predictive value 82%, negative predictive value 84%). Evaluation with transvaginal sonography was accurate in 11 of 14 cases (accuracy 78%, sensitivity 80% specificity 77%, positive predictive value 87%, negative predictive value 66%).

Assessment of Myometrial Invasion in Endometrial Cancer by Transvaginal Sonography, Doppler Ultrasonography, Magnetic Resonance Imaging and Frozen Section

“…Relatively small-scale prospective studies have compared the diagnostic accuracies of TVS and MRI in the preoperative local staging of endometrial cancer, with conflicting results. 8,9 A recent study comparing TVS and MRI determined no difference in diagnostic accuracy for assessment of any invasion. 18 In addition to TVS and MRI, the present study has also evaluated the depth of myometrial evaluation with frozen section and Color Doppler sonography.…”

“…There are few prospective studies that compared the diagnostic accuracies of TVS and MRI in the preoperative local staging of endometrial carcinoma. 8,9 However, there has been no prospective comparison of the accuracy of TVS, MRI, and intraoperative frozen section in the assessment of myometrial invasion. There is also a debate about assessment of myometrial invasion with transvaginal Color Doppler ultrasonography (TV-CDU).…”

Evaluation of endometrial carcinoma on magnetic resonance imaging

“…Ultrasound is the conventional first‐line imaging investigation in patients suspected of endometrial cancer clinically. However, there are conflicting opinions in the use of ultrasound in preoperative staging assessment: Kim et al and Yamashita et al advocate MRI, in which they have demonstrated better staging accuracy, whereas Cagnazzo et al and Delmaschio et al found very similar staging accuracies between the two techniques (28,35–37) . Zarbo et al advocated using MRI only in cases where deep invasion is suspected on ultrasound (38) .…”

Comparative Study of Transvaginal Ultrasound With Histopathology in Diagnosing Endometrial Pathology in Postmenopausal Bleeding

“…2 irregularity of endomyometrial interface indicate abnormality. 15 When fluid was present in the uterine cavity, size of the anechoic area was subtracted from the total thickness. Patients with suboptimal visualization of endometrium were excluded from the study group.…”