You are here

  • Home
  • Archive
  • Volume 31, Issue Suppl 3
  • 433 Myometrial infiltration assessment in low-risk endometrial cancer by 3D transvaginal ultrasound and diffusion-weighted magnetic resonance imaging

Article Text

Article menu

Download PDFPDF

Diagnostics
433 Myometrial infiltration assessment in low-risk endometrial cancer by 3D transvaginal ultrasound and diffusion-weighted magnetic resonance imaging
Free
  1. N Carreras Diéguez1,
  2. M Munmany2,
  3. C De Guirior3,
  4. P Fusté1,
  5. I Matas3,
  6. B Diaz-Feijoo1,
  7. AG Glickman1,
  8. L Buñesch4,
  9. N Agustí1,
  10. C Ros3,
  11. M Sebastià4,
  12. M Del Pino1,
  13. A Saco5,
  14. C Nicolau4,
  15. J Ordi5 and
  16. A Torne1
  1. 1Hospital Clínic de Barcelona, Gynaecologic Oncology Unit, Barcelona, Spain
  2. 2Hospital Clínic de Barcelona, Gynaecology, Obstetrics and Neonatology , Barcelona, Spain
  3. 3Hospital Clínic de Barcelona, Gynaecology, Obstetrics and Neonatology, Barcelona, Spain
  4. 4Hospital Clínic de Barcelona, Radiology, Barcelona, Spain
  5. 5Hospital Clínic de Barcelona, Pathology Department, Barcelona, Spain

Abstract

Introduction/Background*In patients with early-stage, grade 1-2, endometrioid endometrial cancer, preoperative assessment of myometrial invasion is essential to define the need of pelvic and paraaortic lymph node dissection. Our aim was to evaluate the role of three-dimensional transvaginal ultrasound (3D-TVUS) and diffusion-weighted magnetic resonance imaging (DW-RMI) for the assessment of myometrial infiltration in patients with well-differentiated (G1) or moderately differentiated (G2) endometrioid endometrial carcinoma (EC).

Methodology We performed a retrospective observational study. Myometrial infiltration was assessed by 3D-TVUS and DW-MRI in 152 women with G1 or G2 endometroid EC who underwent surgical treatment in a tertiary referral center between 2012 and 2019. Sensitivity, specificity, predictive values and accuracy for the two techniques and for a combination of both were computed. Definitive histopathological data in the surgical specimen regarding myometrial infiltration was used as ‘Gold Standard’.

Result(s)*One hundred and fifty-two patients were included, 120 (79%) patients presented myometrial infiltration <50% in postoperative analysis of surgical specimen and 32 (21%) patients presented deep myometrial infiltration (>50%). 3D-TVUS and DW-MRI showed an agreement of 78.9% with a kappa index of 0.44 for the detection of deep myometrial infiltration. Sensitivity, specificity and accuracy of 3D-TVUS for the detection of deep myometrial infiltration were 71.0%, 80.5% and 78.5% respectively. Evaluation of myometrial infiltration with DW-MRI had a sensitivity, specificity and accuracy of 76.2%, 84.4% and 82.9% respectively. Association of both techniques increased sensitivity and specificity up to 84.6% and 93.2% and provided a low false negative rate (2.3%).

Conclusion*The combination of 3D-TVUS and DW-RMI offers a high sensitivity and specificity to identify deep myometrial infiltration in patients with endometrioid G1 or G2 EC, thus these patients might benefit from performance of both techniques in preoperative evaluation.

https://doi.org/10.1136/ijgc-2021-ESGO.101

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.