Delhi: Transvaginal ultrasound (TVUS) is at par with MRI for accurate assessment of myometrial invasion (MI) in women with endometrial cancer, states a recent study published in the journal Radiology and Oncology.
Anis Cerovac from Tešanj General Hospital in Bosnia and Herzegovina and colleagues conducted the study with an objective to compare the accuracy of preoperative TVUS versus magnetic resonance imaging (MRI) for assessing MI in patients with endometrial cancer. Definitive histopathological diagnosis served as a reference method.
For this purpose, the researchers performed an observational prospective comparative cohort study at a single tertiary care center from 2019 to 2021. It included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed before surgical staging for MI assessment. TVUS methods (Gordon's and Karlsson's) and MRI were used for estimation. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (<50%) and deep (>50%).
60 were eligible for the study out of total of 72 cases diagnosed with EC.
Following were the key findings of the study:
According to the reference method, there were 34 (56.7%) cases in the study with MI <50%, and 26 (43.3%) with MI > 50%.
Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI.
The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant.
Gordon's method calculating MI reached a PPV of 83%, NPV of 83%, 77% sensitivity, 88% specificity, and 83 % overall accuracy.
Karlsson's method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy.
Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy.
"Objective TVUS assessment of myometrial invasion performs with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer," the authors concldued.
Reference:
Cerovac, A., Ljuca, D., Arnautalić, L., Habek, D., Bogdanović, G., Mustedanagić Mujanović, J., & Grgić, G. (2022). Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study: Myometrial invasion in endometrial cancer. Radiology and Oncology, 56(1). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/3762