Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer

Abstract

Objectives: To evaluate the accuracy of transvaginal three-dimensional ultrasound with volume contrast imaging (VCI) for preoperative assessment of depth of myometrial invasion and cervical involvement in women with endometrial cancer.

Methods: Transvaginal volume acquisition of the uterus was performed in 60 consecutive patients with histological diagnosis of endometrial cancer who were scheduled for primary surgical treatment. Depth of myometrial invasion and presence or absence of cervical involvement were assessed using VCI in multiplanar display mode. Results were compared to final postoperative histopathological findings. Patients with histological high-risk cell types, including Grade 3 endometrioid adenocarcinoma, clear cell carcinoma, papillary serous carcinoma and carcinosarcoma, were excluded.

Results: Forty patients were included in the analysis. The accuracy of VCI in assessing single-stage myometrial invasion (superficial or deep) was 92.5%. In the prediction of deep myometrial invasion, sensitivity, specificity, PPV and NPV of VCI were 100%, 89.7%, 78.6% and 100%, respectively. The accuracy of VCI in assessing cervical involvement was 90.0%. Sensitivity, specificity, PPV and NPV of VCI in predicting the presence of cervical involvement were 100%, 86.2%, 73.3% and 100%, respectively.

Conclusion: Transvaginal VCI is an uncomplicated method that is able to predict with reasonable accuracy the depth of myometrial invasion and cervical involvement in women with endometrial cancer.

Keywords: VCI; endometrial carcinoma; three-dimensional ultrasound; volume ultrasound.