|Accuracy of Imaging in Preoperative Local Staging of Endometrial Cancer: Could Imaging Predict low Risk Patients?|
|Maryam Rahmani1 , Samira Heydar1, Azamsadat mousavi2, Nasrin Ahmadinejad1, Shilan Azhdeh1, Majid Shakiba1|
|1Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical science, Tehran, Iran
22. Department of Oncology and Gynecology, Tehran University of Medical Science, Tehran, Iran
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Keywords : Endometrial cancer, Transvaginal sonography, Doppler ultrasonography, Magnetic resonance imaging, Myometrial invasion
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Objective: In this study we are going to evaluate diagnostic accuracy of MRI and TVS in identifying depth of myometrial invasion and cervical involvement and also its relationship with the uterine arteries RI and PI in endometrial carcinoma.
Methods: We performed a prospective study on 45 women with histologically confirmed diagnosis of endometrial carcinoma. The study was performed from October 2009 to December 2012. All the patients were evaluated by 3T MRI and TVS and transvaginal color Doppler sonography of uterine arteries . All patient underwent hysterectomy and the result of imaging and pathologic studies were compared.
Results: Mean age was 54.5±10.8 years (33 to 77 years), mean gravid was 3.93±2.8 and the mean parity was 3.9±2.5.The pathology results indicated 29 patients (64.4%) in stage Ia and 16 patients (35.6%) in stage Ib. Mean endometrial thickness in Stage Ia patients was 18.4±14.4 mm and in stage Ib was 38.5±11.5 mm. Transvaginal sonography also showed Positive predictive value (PPV) of 76.5%, Negative predictive value (NPV) of 88.9%, sensitivity of 81.3%, specificity of 85.7% and accuracy of 84.1% for assessment depth of myometrial invasion in endometrial carcinoma. We found Positive Predictive Value (PPV) of 86.7%, Negative Predictive Value (NPV) of 92.3%, sensitivity of 86.7%, specificity of 92.3% and accuracy of 90.2% for MRI study.
Conclusion: TVS can evaluate depth of myometrial invasion with acceptable accuracy when MRI is not available or cost-effective or is contraindicated.
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