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18 March 2019 : Clinical Research  

Magnetic Resonance Imaging (MRI) and Three-Dimensional Transvaginal Ultrasonography Scanning for Preoperative Assessment of High Risk in Women with Endometrial Cancer

Ting Yang1ABCDEFG, Sijuan Tian1B, Yang Li2BC, Xueye Tian1BC, Wei Wang1BC, Juan Zhao1BCF, Meili Pei1EF, Minyi Zhao1CDEF, Li Wang1BCD, Shimin Quan1CD, Xiaofeng Yang1ABC*

DOI: 10.12659/MSM.915276

Med Sci Monit 2019; 25:2024-2031

Abstract

BACKGROUND: To evaluate the diagnostic performance of MRI and 3D-TVS for assessment of deep myometrial invasion (MI), cervical involvement (CI), and Lymph node metastases (LNM) in endometrial cancer staging before surgery.

MATERIAL AND METHODS: From January 2016 to December 2017, we reviewed data from 314 women with endometrial cancer who underwent preoperative MRI and 3D-TVS before surgery. The diagnostic sensitivity, specificity, PPV, NPV, and accuracy in detecting MI, CI, and LNM were estimated based on ultimate pathology results.

RESULTS: The sensitivity, specificity, PPV, NPV, and accuracy of MRI in the diagnosis of MI were 89.19%, 88.97%, 67.35%, 97.99%, and 89.01%, respectively, and the indexes of 3D-TVS for MI were 86.36%, 91.07%, 79.17%, 94.44%, and 89.74%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of MRI for CI were 75% and 92.35%, 40.9%, 98.13%, and 91.2%, respectively. The indicators of 3D-TVS were 77.78%, 94.29%, 63.63%, 97.06%, and 92.4%, respectively. There were no significant differences in sensitivity, specificity, NPV, and accuracy between MRI and 3D-TVS in the diagnosis of MI and CI. For MI and CI, the sensitivity of combined MRI and 3D-TVS was higher than any other single method (P<0.05). For LNM, the sensitivity, specificity, PPV, NPV, and accuracy of MRI were 58.33%, 96.26%, 63.63%, 95.37%, and 92.43%, respectively.

CONCLUSIONS: 3D-TVS is equivalent to MRI in predicting MI and CI. Combined MRI and 3D-TVS can improve the assessment sensitivity, and they are useful in optimizing individualized surgical procedures. The sensitivity of MRI for LNM prediction needs to be improved.

Keywords: Endometrial Neoplasms, Magnetic Resonance Imaging, Ultrasonography, Cervix Uteri, Endosonography, Imaging, Three-Dimensional, Myometrium, Preoperative Care, Radionuclide Imaging, Sensitivity and Specificity, Vagina, Vaginal Neoplasms

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750