Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study Cover

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Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study

Radiology and Oncology

Volume 56 (2022): Issue 1 (March 2022)

By: Anis Cerovac, Dzenita Ljuca, Lejla Arnautalic, Dubravko Habek, Gordana Bogdanovic, Jasminka Mustedanagic-Mujanovic and Gordana Grgic

Open Access

|Feb 2022

Figures & Tables

Assessment of myometrial invasion in patients with transvaginal ultrasonography (TVUS). Stage IA endometrial cancer in a 61-year-old postmenopausal woman, correctly diagnosed by TVUS and MRI. Karlsson’s method indicating infiltration of superficial muscle (29%) (A). Stage IA endometrial cancer in a 53-year-old postmenopausal woman. Gordon’s method indicating infiltration of superficial muscle (35%) (B).

Assessment of myometrial invasion in patients with transvaginal ultrasonography (TVUS). Stage IB endometrial cancer in a 78-year-old postmenopausal woman, correctly diagnosed by TVUS and MRI. Karlsson’s method indicating infiltration of deep muscle (58%) (A). Stage IB endometrial cancer in an 83-year-old postmenopausal woman. Gordon’s method indicating infiltration of deep muscle (73%) (B).

Assessment of myometrial invasion in patients with MRI, sagittal T2-weighted. Stage IA endometrial cancer in a 68-year-old postmenopausal woman, correctly diagnosed by TVUS and MRI. Arrow shows blurring of the junctional zone and the infiltration of superficial muscle (20%) (A). Stage IB endometrial cancer in a 58-year-old postmenopausal woman, correctly diagnosed by TVUS and MRI. Arrows refers to deep myometrial infiltration (60%) (B).

Receiver operating characteristics (ROC) analysis for percentage assessment of myometrial invasion (MI) with transvaginal ultrasound (TVUS) by Gordon’s and Karlsson’s, and with MRI

Myometrial invasion in endometrial cancer according to histopathology, transvaginal ultrasonography and magnetic resonance imaging

Histopathology	TVUS (Gordon)		TVUS (Karlsson)		MRI		Total N(%)
Histopathology							Total N(%)
	≤ 50% N(%)	> 50% N(%)	≤ 50% N(%)	> 50% N(%)	≤ 50% N(%)	> 50% N(%)
≤ 50% N (%)	30 (88.2)	4 (11.8)	30 (88.2)	4 (11.8)	29 (85.3)	5 (14.7)	34 (100)
> 50% N(%)	6 (23.1)	20 (76.9)	8 (30.8)	18 (69.2)	1 (3.8)	25 (96.2)	26 (100)
Total	36 (60)	24 (40)	38 (63.3)	22 (36.7)	30 (50)	30 (50)	60 (100)

Demographic and clinical characteristics of 60 women with histologically confirmed endometrial cancer

Characteristics	Value (%)
Age (years)	60 (40–83)
Body mass index (kg/m²)	32.05 (21.6–49.2)
Postmenopausal	45 (75)
Myometrial invasion
Superficial (≤ 50 %)	34 (56.7)
Deep (> 50%)	26 (43.3)
Hystological grade
Grade 1	18 (30)
Grade 2	35 (58)
Grade 3	7 (12)

Diagnostic performance of transvaginal ultrasonography and magnetic resonance imaging in predicting myometrial invasion in endometrial cancer

Diagnostic test measure	TVUS (Gordon)	TVUS (Karlsson)	MRI
Diagnostic test measure
	%, (95% CI)	%, (95% CI)	%, (95% CI)
Accuracy	83 (70–92)	80 (67–88)	90 (78–93)
Sensitivity	77 (62–87)	69 (54–79)	97 (83–99)
Specificity	88 (77–96)	88 (77–96)	85 (75–88)
Positive predictive value	83 (67–94)	82 (64–93)	83 (72–87)
Negative predictive value	83 (72–90)	79 (69–86)	97 (85–99)
Likelihood Ratio of a Positive Test	6.54 (2.65–19.00)	5.89 (2.30–18.17)	6.54 (3.31–8.37)
Likelihood Ratio of a Negative Test	0.26 (0.14–0.50)	0.35 (0.22–0.60)	0,05 (0.002–0.23)

Representation of the areas below the receiver operating characteristics (ROC) curve (AUC) for percentage assessment of MI with transvaginal ultrasound (TVUS) by Gordon and Karlsson, and with MRI

Method of assessment	AUC	P	95% CI for AUC
Method of assessment	AUC	P	Lower limit	Upper limit
TVUS (Gordon)	0.872	< 0.001	0.769	0.965
TVUS (Karlsson)	0.865	< 0.001	0.766	0.964
MRI	0.911	< 0.001	0.833	0.989

DOI: https://doi.org/10.2478/raon-2022-0005 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 37 - 45

Submitted on: Sep 3, 2021

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Accepted on: Dec 13, 2021

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Published on: Feb 11, 2022

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

endometrial neoplasms,

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2022 Anis Cerovac, Dzenita Ljuca, Lejla Arnautalic, Dubravko Habek, Gordana Bogdanovic, Jasminka Mustedanagic-Mujanovic, Gordana Grgic, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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