The prediction of myometrial infiltration by three-dimensional ultrasonography in patients with endometrial carcinoma: a validation study from Ege University Hospital.

Abstract

Aim: To predict the myometrial invasion with three-dimensional (3D) ultrasonography in a cohort of patients with endometrial carcinoma by a previously described technique. Material and methods: The moyometrial infiltration was evaluated by 3D ultrasonography before surgery in 54 patients with endometrial carcinoma. After scanning the whole uterus by ultrasonography, three perpendicular planes were identified to find the shortest myometrial tumor-free distance to serosa (TDS) by examining the lateral, anterior, posterior, and fundal parts of the myometrium. Myometrial infiltration was also estimated by the subjective impression of the examiner. The reference standards consist of myometrial infiltration and TDS which are measured by an experienced pathologist. Results: Forty-five patients (age range 45-86 years) were included for the final analysis. Myometrial invasion was ˂50% in 36 and ≥50% in 9 cases at histologic sections. The TDS which is measured with 3D ultrasonography was positively correlated with histologically measured TDS (r=0.474, p=0.001). The best cut-off value for ultrasonographically measured TDS was 9 mm with a sensitivity of 89%, specifity of 61%, positive predictive value of 36%, and negative predictive value of 96%. Subjective impression has a sensitivity of 100%, specifity of 88%, positive predictive value of 69%, and negative predictive value of 100%. Cervical involvement was correctly identified in all 6 cases by subjective impression. Conclusion: This validation study confirms the 3D ultrasonography as a valuable tool for the evaluation of myometrial infiltration in patients with endometrial carcinoma.

Three‐dimensional transvaginal ultrasound vs magnetic resonance imaging for preoperative staging of deep myometrial and cervical invasion in patients with endometrial cancer: systematic review and meta‐analysis

“…One of the first prospective studies on the use of 3D‐TVS demonstrated that subjective impression of DMI had an overall sensitivity of 92.6% and a specificity of 82.3% 12 . Subsequently, Ergenoglu et al 13 . reported that 3D‐TVS had a sensitivity of 100% and a specificity of 88% for the diagnosis of DMI.…”

“…Subsequently, Ergenoglu et al . 13 reported that 3D‐TVS had a sensitivity of 100% and a specificity of 88% for the diagnosis of DMI.…”

“…In recent years, the potential of three‐dimensional TVS (3D‐TVS) to replace MRI has been studied. Studies comparing 3D‐TVS and MRI have shown similar DTA in assessing DMI and cervical invasion 12–15 . A meta‐analysis comparing two‐dimensional TVS (2D‐TVS) and MRI for the preoperative detection of myometrial infiltration has been published 11 , but no meta‐analysis has compared the DTA of MRI with that of 3D‐TVS in preoperative staging.…”

Predictability of myometrial, lower uterine segment and cervical invasion with 3D transvaginal ultrasonography and magnetic resonance imaging in endometrial cancer patients: a prospective cohort study

“…The authors concluded that subjective impression of depth invasion had a sensitivity of 92.6%, specificity of 82.3%, negative predictive value of 96.6% and a positive predictive value of 67.7%. Ergenoglu et al reported in 45 patients that subjective impression had a sensitivity of 100%, a specificity of 88%, a positive predictive value of 69% and a negative predictive value of 100% [12].…”

“…It provides an evaluation in three different axes and has an advantage to store the image and examine the data later and repeatedly. In a recent study the sensitivity, specificity and negative predictive value of 3D-US for detecting deep myometrial invasion in endometrial cancer patients were 100%, 88% and 100%, respectively [12].…”