Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

Alcázar, Juan Luis; Pascual, M.; Ajossa, Silvia; Lorenzo, Cristina de; Piras, A.; Hereter, L.; Juez, L.; Fabbri, Paola; Graupera, B.; Guerriero, S.

doi:10.7863/ultra.16.06002

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…In most benign lesions, the color score was ≤2 points, while, the color score was ≥3 points in most malignant lesions. The results of Alcazar et al (17) was similar to ours. Meanwhile, Alcazar et al confirmed that the reproducibility of assigning the IETA color score for assessing endometrial vascularization using three-dimensional volumes was good regardless of the experience of the examiner.…”

Section: Discussionsupporting

confidence: 89%

“…Early diagnosis of benign and malignant lesions in uterine cavity or endometrium is of great significance for early clinical treatment and improvement of prognosis (2,38). The imaging examinations are important methods, especially transvaginal ultrasonography (17).…”

Section: Discussionmentioning

confidence: 99%

“…In the past decades, there were several studies (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) on the clinical application of IETA expert consensus, with mixed praises and criticisms on its application effects. Among them, it was criticized that there were too many descriptive indicators of IETA ultrasound characteristics, which took a long time, and the consistency among different observers was poor (22).…”

Section: Introductionmentioning

confidence: 99%

“…In this study, we converted the normalized description of IETA ultrasound characteristics into a simple scoring method based on the existing IETA-related research results (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) and the previous research experience of our project team. Meanwhile, we combined the results of tumor biomarkers to evaluate the diagnostic efficacy of benign and malignant lesions in uterine cavity or endometrium.…”

Section: Introductionmentioning

confidence: 99%

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Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Lin

Zhao²,

Zhu³

et al. 2021

Front. Oncol.

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ObjectivesTo evaluate International Endometrial Tumor Analysis (IETA) ultrasonographic characteristics simple scoring method and tumor biomarkers for the diagnosis of uterine cavity and endometrial lesions.MethodsWe classified and scored the normalized description of IETA ultrasonic characteristics, according to IETA expert consensus literature, previous IETA-related research articles, and the previous research experience of this project group. We conducted a retrospective analysis of the ultrasound images of 594 patients enrolled from January 2017 to June 2020, scored them item by item, and finally calculated the total score of each case. Meanwhile, we combined the results of seven tumor biomarkers. The objective was to evaluate the sensitivity, specificity, coincidence rate, and the area under receiver operating characteristic (ROC) curve of IETA ultrasonographic characteristics simple scoring method and tumor biomarkers for benign and malignant uterine cavity or endometrial lesions. The diagnostic efficiency between the combined method and the single method was compared.ResultsA total of 594 cases were confirmed by postoperative pathology or surgery records, including 475 benign lesions and 119 malignant lesions. In the simple ultrasound scoring method, the average score of benign lesions was 3.879 ± 1.279 and that of malignant lesions was 9.676 ± 4.491. If ≥6.5 points was taken as the cutoff value for the judgment of malignant lesions, the sensitivity, specificity, coincidence rate, and the area under receiver operating characteristic (ROC) curve (AUC) were 76.5%, 96.0%, 92.1%, and 0.935, respectively. The difference in tumor antigen 19-9 (CA19-9) and human epididymal protein 4 (HE4) between benign and malignant lesions was statistically significant (all p ≤ 0.01). The other five tumor biomarkers (CA125, CA15-3, SCC-Ag, AFP, and CEA) showed no statistically significant difference in benign and malignant lesions. If the value of CA19-9 ≥13.96 U/ml was taken as cutoff value, the sensitivity, specificity, and coincidence rate of the diagnosis of endometrial benign and malignant lesions were 54.8%, 74.7%, and 70.7%, respectively, and the AUC was 0.620. If the value of HE4 ≥ 39.075 pmol/L was taken as cutoff point, the sensitivity, specificity, coincidence rate, and AUC were 77.4%, 67.9%, 69.8%, and 0.796, respectively. The sensitivity was increased to 97.6% and the AUC was 0.939 when IETA ultrasound characteristics simple scoring method combined CA19-9 and HE4 in parallel test.ConclusionsIn IETA ultrasound characteristics simple scoring method, with ≥6.5 points as the cutoff value, it could quickly and accurately assess the benign and malignant in uterine cavity and endometrial lesions, with high diagnostic value. The diagnostic efficacy of seven tumor biomarkers was all mediocre. Combining with these two methods, the comprehensive diagnosis could improve sensitivity and accuracy and reduce the risk of missed diagnosis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Lin

Zhao²,

Zhu³

et al. 2021

Front. Oncol.

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“…The methodology employed in this investigation is consistent with that of the International Endometrial Tumor Analysis collaborative group. 15,16 The clinical importance of these methodologies should be recognized for the impact they can have on patient care, since there is often difficulty in properly obtaining a diagnosis of EC when it presents as PMB. 17,18 An example of this situation is when cervical stenosis is encountered, which can prevent histologic sampling of the endometrium, as was encountered in this case series.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Three-Dimensional Transvaginal Sonography for Staging of Endometrial Neoplasia

Fernández

Levine

Dini

et al. 2018

Journal of Diagnostic Medical Sonography

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Atypical endometrial hyperplasia (AEH) is also referred to as carcinoma in situ, or endometrial carcinoma (EC), stage 0, although this is not currently consistent with the International Federation of Gynecology and Obstetrics staging. As the continuum of endometrial neoplasia is recognized to extend from AEH through EC, we may need to predict noninvasively its natural biological behavior, to better prepare the gynecologic oncologist surgeon planning to perform the required surgical treatment(s). 1 It may be particularly useful to identify women experiencing postmenopausal bleeding (PMB) for evaluation, because a significant number has yet been diagnosed with EC. 2 When EC is found, its staging determines the optimal surgical treatment, and the staging itself correlates with the depth of myometrial invasion and lymphatic spread. 3 Recently, determining the cancer invasion in a sentinel node has been used to predict the likelihood of cancer spreading to those pelvic lymph nodes and therefore the possible need for lymphadenectomy. 4-6 Specifically, for stage IB or greater, lymphadenectomy should be performed for maximum patient survival. Considering the lymphedema associated with lymphadenectomy, the need for performing the procedure may be ideally predicted prior to the surgical treatment itself, so as to possibly avoid or reduce the associated morbidities. If the need for lymphadenectomy can be determined by presurgical three-dimensional transvaginal sonography (3D TVS), benefit to both the surgeon and patient may be provided. Therefore, this study was designed to investigate the use of 3D TVS techniques and to identify the features of this neoplastic entity preoperatively, compared with those features with postsurgical histology. Materials and Methods All patients in this investigation who were clinically diagnosed with AEH or EC were examined sonographically prior to surgery using 3D TVS gray-scale power 794177J DMXXX10.

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Standardized IETA criteria enhance accuracy of junior and intermediate ultrasound radiologists in diagnosing malignant endometrial and intrauterine lesions

Chen,

Wang,

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectivesTo transform the standardized descriptions of the ultrasound characteristics of endometrial and intrauterine lesions devised by the International Endometrial Tumor Analysis (IETA) group into a practical scoring method and to investigate whether application of this method enhances the diagnostic accuracy of ultrasound radiologists with different levels of experience in detecting malignancy compared with subjective assessment.MethodsThis was a retrospective study of 855 patients with endometrial and/or intrauterine lesions, who were divided into a training (n = 600) and a validation (n = 255) set. Ultrasound radiologists with varying levels of experience (expert, intermediate and junior) evaluated all lesions by subjective assessment and according to IETA rules. Using IETA rules, the experts identified signs of malignancy in the training set, assigned scores for each indicator and validated the scoring method in the validation set. The intermediate‐level and junior ultrasound radiologists reassessed the malignancy of the lesions using the IETA scoring method and compared their classifications with those made previously by subjective assessment. Postsurgical pathological evaluation was used as the reference standard.ResultsUsing subjective assessment, the experts demonstrated the highest level of diagnostic accuracy, with a sensitivity of 85.0%, specificity of 94.3% and an area under the receiver‐operating‐characteristics curve (AUC) of 0.897. Applying the IETA scoring method (comprising eight ultrasound characteristics that contributed to the total score) with a threshold of > 25 points for the diagnosis of malignancy achieved a sensitivity of 84.7%, specificity of 94.7% and AUC of 0.9533 in the training set, with similar performance in the validation set, when performed by experts. Using the IETA scoring method, both junior and intermediate ultrasound radiologists showed improvement in sensitivity (from 55.5% to 74.8% and from 70.2% to 77.1%, respectively), specificity (from 88.4% to 91.5% and from 87.4% to 92.2%, respectively) and AUC (from 0.704 to 0.827 and from 0.793 to 0.841, respectively) for diagnosing malignant lesions.ConclusionsThe IETA scoring method exhibits high diagnostic efficacy for malignant endometrial and intrauterine lesions. This method compensates for the lack of experience among junior and intermediate‐level ultrasound radiologists, enhancing their diagnostic skill to a level nearing that of experienced senior ultrasound radiologists. Further research is essential to validate the practicality of implementing this method and to confirm its clinical value. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

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Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

Abstract: The reproducibility of assigning the IETA color score for assessing endometrial vascularization using 3-dimensional volumes is good or very good regardless of the experience of the examiner.

Cited by 7 publications

References 14 publications

Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Combination IETA Ultrasonographic Characteristics Simple Scoring Method With Tumor Biomarkers Effectively Improves the Differentiation Ability of Benign and Malignant Lesions in Endometrium and Uterine Cavity

Predictive Value of Three-Dimensional Transvaginal Sonography for Staging of Endometrial Neoplasia

Standardized IETA criteria enhance accuracy of junior and intermediate ultrasound radiologists in diagnosing malignant endometrial and intrauterine lesions

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