scholarly journals OP09.01: The diagnostic accuracy of ultrasound in assessment of myometrial and cervical invasion in endometrial cancer: subjective assessment vs. objective techniques

2014 ◽  
Vol 44 (S1) ◽  
pp. 87-88
Author(s):  
F. Frühauf ◽  
D. Fischerová ◽  
M. Zikan ◽  
I. Pinkavova ◽  
P. Dundr ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Diagnostic Accuracy ◽  
Subjective Assessment

scholarly journals The Diagnostic Accuracy of Ultrasound in Assessment of Myometrial Invasion in Endometrial Cancer: Subjective Assessment versus Objective Techniques

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Filip Frühauf ◽  
Michal Zikan ◽  
Ivana Semeradova ◽  
Pavel Dundr ◽  
Kristyna Nemejcova ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Reliable Method ◽  
Myometrial Invasion ◽  
Subjective Assessment ◽  
Diameter Ratio ◽  
Anteroposterior Diameter ◽  
Ultrasound Evaluation ◽  
Better Than

The aim of this study was to assess the diagnostic accuracy of subjective ultrasound evaluation of myometrial invasion of endometrial cancer and to compare its accuracy to objective methods. All consecutive patients with histologically proven endometrial cancer, who underwent ultrasound evaluation followed by surgical staging between January 2009 and December 2011, were prospectively enrolled. Myometrial invasion was evaluated by subjective assessment using ultrasound (<50% or ≥50%) and calculated as deepest invasion/normal myometrium ratio (Gordon’s ratio) and as tumor/uterine anteroposterior diameter ratio (Karlsson’s ratio). Histological assessment from hysterectomy was considered the gold standard. Altogether 210 patients were prospectively included. Subjective assessment and two objective ratios were found to be statistically significant predictors of the myometrial invasion (AUC = 0.65, p value < 0.001). Subjective assessment was confirmed as the most reliable method to assess myometrial invasion (79.3% sensitivity, 73.2% specificity, and 75.7% overall accuracy). Deepest invasion/normal myometrium (Gordon’s) ratio (cut-off 0.5) reached 69.6% sensitivity, 65.9% specificity, and 67.3% overall accuracy. Tumor/uterine anteroposterior diameter (Karlsson’s) ratio with the same cut-off reached 56.3% sensitivity, 76.4% specificity, and 68.1% overall accuracy. The subjective ultrasound evaluation of myometrial invasion performed better than objective methods in nearly all measures but showed statistically significantly better outcomes only in case of sensitivity.

The diagnostic accuracy of magnetic resonance imaging in detecting cervical involvement in endometrial cancer

2006 ◽  
Vol 103 (2) ◽  
pp. 431-434 ◽  
Author(s):  
Hans Nagar ◽  
Stephen Dobbs ◽  
H. Raymond McClelland ◽  
John Price ◽  
W. Glenn McCluggage ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Endometrial Cancer ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Resonance Imaging ◽  
Cervical Involvement

Diagnostic Accuracy of Magnetic Resonance Imaging in Endometrial Cancer

2012 ◽  
Vol 22 (6) ◽  
pp. 1020-1025 ◽  
Author(s):  
Mark H. McComiskey ◽  
W. Glenn McCluggage ◽  
Arthur Grey ◽  
Ian Harley ◽  
Stephen Dobbs ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Endometrial Cancer ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Myometrial Invasion ◽  
Preoperative Assessment ◽  
Tumor Board ◽  
Resonance Imaging ◽  
Outer Half

ObjectivesThe objectives of this study were to investigate the accuracy of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion in the preoperative assessment of women with endometrial cancer and to quantify the impact of MRI as an adjunct to predicting patients requiring full surgical staging.MethodsThis was a diagnostic accuracy study of prospective cases in conjunction with STARD guidelines using collected data from a tumor board within a cancer network. Consecutive series of all endometrial cancers in Northern Ireland over a 21-month period was discussed at the Gynaecological Oncology Multidisciplinary Team/tumor board meeting. This study concerns 183 women who met all the inclusion criteria. Main outcome measure was the correlation between the depth of myometrial invasion suggested by preoperative MRI study and the subsequent histopathological findings following examination of the hysterectomy specimen. Secondary end point was how MRI changed management of women who required surgery to be performed at a central cancer center.ResultsFor the detection of outer-half myometrial invasion, overall sensitivity of MRI was 0.73 (95% confidence interval [CI], 0.59–0.83), and specificity was 0.83 (95% CI, 0.76–0.89). The positive predictive value was 0.63 (95% CI, 0.50–0.74), and negative predictive value was 0.89 (95% CI, 0.82–0.93). Positive likelihood ratio was 4.35 (95% CI, 2.87–6.61), and negative likelihood ratio was 0.33 (95% CI, 0.21–0.52). Magnetic resonance imaging improved the sensitivity and negative predictive value of endometrial biopsy alone in predicting women with endometrial cancer who require full surgical staging (0.73 vs 0.65 and 0.80 vs 0.78, respectively).ConclusionsPreoperative pelvic MRI is a moderately sensitive and specific method of identifying invasion to the outer half of myometrium in endometrial cancer. Addition of MRI to preoperative assessment leads to improved preoperative assessment, triage, and treatment.

scholarly journals Simple radiologic assessment of visceral obesity and prediction of surgical morbidity in high-risk endometrial cancer: a reliability and accuracy pilot study

2021 ◽  
Author(s):  
Alejandro Correa-Paris ◽  
Verónica Gorraiz Ochoa ◽  
Alicia Hernández ◽  
Juan Gilabert-Estelles ◽  
Berta Díaz-Feijoo ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Minimally Invasive ◽  
Diagnostic Accuracy ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Visceral Obesity ◽  
Surgical Staging ◽  
Surgical Morbidity ◽  
Minimally Invasive Surgical

Objective: To evaluate the reliability of sagittal abdominal diameter (SAD)—a surrogate of visceral obesity—in MRI, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy. Design: A multicentre reliability (phase 1) and accuracy (phase 2) cohort study. Setting: Three Spanish referral hospitals. Population: High-risk endometrial cancer patients undergoing minimally invasive surgical staging. Patients were classified into subgroups: conventional vs. robotic-assisted laparoscopy, and transperitoneal vs. extraperitoneal technique. Methods: Retrospective analysis of data from the STELLA-2 randomized controlled trial. In the first phase, we measured the agreement of three SAD measurements (at the umbilicus, the renal vein, and the inferior mesenteric artery) and selected the most reliable one. In phase two, we evaluated the diagnostic accuracy of SAD to predict surgical morbidity. Main Outcome Measures: surgical morbidity was defined by a core outcome set including variables related to blood loss, operative time, surgical complications, and para-aortic lymphadenectomy difficulty. Results: In phase one, all measurements showed good inter-rater and intra-rater agreement. Umbilical SAD was the most reliable one. In phase two, we included 136 patients. Umbilical SAD had a good diagnostic accuracy to predict surgical morbidity in patients undergoing transperitoneal laparoscopic lymphadenectomy (0.73 in ROC curve). It performed better than BMI and other anthropometric measurements. We calculated a cut-off point of 246 mm (sensitivity: 0.56 and specificity: 0.80). Conclusions: Umbilical SAD is a simple, reliable, and potentially useful measurement to predict surgical morbidity in endometrial cancer patients undergoing minimally invasive surgical staging, especially when facing transperitoneal aortic lymphadenectomy.

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