The diagnostic accuracy of 3D ultrasound compared to 2D ultrasound and MRI in the assessment of deep myometrial invasion in endometrial cancer patients: A systematic review

Ziogas, Apostolos C; Xydias, Emmanouil; Kalantzi, Sofia; Papageorgouli, Despoina; Liasidi, Polyxeni-Natalia; Lamari, Ioanna; Daponte, Alexandros

doi:10.1016/j.tjog.2022.06.002

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…In regard to the use of 3D transvaginal ultrasound, it did not show improved diagnostic accuracy of myometrial infiltration in comparison to 2D ultrasound in a large multicentre study (25). However, a recent systematic review reported that 3D-TVUS is at least comparable, in fact superior in one study, to MRI and mostly equivalent to 2D-TVUS, thus underlining a promising role (26). A total of four examiners participated in the study, but due to a low number of exams performed by each physician it was not possible to understand slight differences in the overall diagnostic accuracy rate per physician and potential differences between experts and residents.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Preoperative staging of uterine cancer: can transvaginal ultrasonography play a role?

et al. 2023

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IntroductionPreoperative staging of uterine cancer has recently been implied as an important contribution to an accurate selection of low-risk cases, ultimately avoiding unnecessary lymph node debulking. The aim of this study was to evaluate the validity of transvaginal ultrasonography (TVS) in preoperative staging of uterine cancer in comparison to pelvic magnetic resonance imaging (MRI) and permanent section.MethodsWe conducted a prospective longitudinal multicenter trial between 2017 and 2018. Inclusion criteria comprised cases of endometrial neoplasia histologically confirmed or strong imaging suspicion, candidates for elective surgery as primary treatment. Proportions of Agreement (PA), kappa statistic (K), sensitivity, specificity and accuracy were calculated with 95% confidence intervals (95%CI).ResultsEighty-two patients were eligible for the study, presenting a mean age of 68 years (standard deviation 11). In what concerns the TVS evaluation of myometrial invasion, the subjective and objective methods of Gordon and Karlsson presented a sensitivity of 79%, 79% and 67% [95%CI 63-91; 63-91; 50-81], a specificity of 65%, 58% and 79% [95%CI 49-79; 42-73; 64-89] and an overall accuracy of 72%, 68% and 73% [95%CI 61-81; 57-78; 63-82]. MRI presented respectively a sensitivity, specificity and overall accuracy of 92%, 70% and 82% [95%CI 77-98; 52-85; 71-90]. Regarding cervical involvement, the sensitivity was respectively 31%, 50% and 67% [95%CI 9-61; 21-79; 35-90] for the subjective method, objective TVS and MRI, and the specificity was 98%, 90% and 100% [95%CI 92-100; 77-97; 94;100]. Agreement between TVS and MRI was superior in the assessment of cervical invasion, with PA ranging from 0.82 to 0.93 and K from 0.45 to 0.58, in comparison to myometrial invasion with PA ranging from 0.68 to 0.73 and K from 0.31 to 0.50. Considering the assessment of cervical involvement, as MRI showed a specificity of 100% it is not possible to increase the specificity. However, it was possible to increase the sensitivity, considering the combination of TVS with objective approach and MRI.ConclusionTVS may have a promising role as a tool for preoperative staging of endometrial carcinoma, presenting a performance that approximates to MRI, with a higher agreement in the assessment of cervical invasion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative staging of uterine cancer: can transvaginal ultrasonography play a role?

et al. 2023

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“…In our study, the pooled sensitivity was similar to these data, and TVS specificity was better. In a recent meta-analysis by Ziogas et al, no significant difference was observed between 2D-TVS and 3D-TVS in terms of sensitivity and specificity (80.4% vs. 77.6% and 82.8% vs. 81.6%, respectively, p = 0.960 and p = 0.733) [ 13 ]. Perniola et al reported that tumor volume estimation on 2D-TVS, 3D-TVS and MRI showed correlations among all three methods, indicating that 2D-TVS can be sufficient for myometrial infiltration assessment [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, this is currently not recommended by the most recent ESGO/ESTRO/ESP guideline [ 4 ]. Three-dimensional transvaginal ultrasound does not seem to be a superior method compared to two-dimensional TVS in terms of diagnostic accuracy and interrater agreement [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for the Detection of Myometrial Infiltration in Endometrial Cancer: A Systematic Review and Meta-Analysis

Madár,

Szabó,

Vleskó

et al. 2024

Cancers

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In endometrial cancer (EC), deep myometrial invasion (DMI) is a prognostic factor that can be evaluated by various imaging methods; however, the best method of choice is uncertain. We aimed to compare the diagnostic performance of two-dimensional transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in the preoperative detection of DMI in patients with EC. Pubmed, Embase and Cochrane Library were systematically searched in May 2023. We included original articles that compared TVS to MRI on the same cohort of patients, with final histopathological confirmation of DMI as reference standard. Several subgroup analyses were performed. Eighteen studies comprising 1548 patients were included. Pooled sensitivity and specificity were 76.6% (95% confidence interval (CI), 70.9–81.4%) and 87.4% (95% CI, 80.6–92%) for TVS. The corresponding values for MRI were 81.1% (95% CI, 74.9–85.9%) and 83.8% (95% CI, 79.2–87.5%). No significant difference was observed (sensitivity: p = 0.116, specificity: p = 0.707). A non-significant difference between TVS and MRI was observed when no-myometrium infiltration vs. myometrium infiltration was considered. However, when only low-grade EC patients were evaluated, the specificity of MRI was significantly better (p = 0.044). Both TVS and MRI demonstrated comparable sensitivity and specificity. Further studies are needed to assess the presence of myometrium infiltration in patients with fertility-sparing wishes.

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“…Ultrasonography is the most commonly used screening method for endometrial cancer, but the rate of missed diagnoses is high and is greatly influenced by the level of the operator [5,6] ; CT has the advantages of a wide scanning range, high speed, and high image density resolution [7] .In clinical assessment, due to limitations in soft tissue resolution, there is a lack of accuracy in terms of diagnosing the depth of endometrial cancer involvement in the myometrium and whether stage II endometrial cancer involves the cervix. Currently, hysteroscopic localized biopsy or hysteroscopy combined with segmental diagnostic scraping is recommended as the "gold standard" for the diagnosis of endometrial cancer [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Construction and validation of a prediction model for preoperative prediction of Ki-67 expression in endometrial cancer patients by apparent diffusion coefficient

Zhang,

Jing,

et al. 2024

Clinical Radiology

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The diagnostic accuracy of 3D ultrasound compared to 2D ultrasound and MRI in the assessment of deep myometrial invasion in endometrial cancer patients: A systematic review

Cited by 9 publications

References 35 publications

Preoperative staging of uterine cancer: can transvaginal ultrasonography play a role?

Preoperative staging of uterine cancer: can transvaginal ultrasonography play a role?

Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for the Detection of Myometrial Infiltration in Endometrial Cancer: A Systematic Review and Meta-Analysis

Construction and validation of a prediction model for preoperative prediction of Ki-67 expression in endometrial cancer patients by apparent diffusion coefficient

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