Comparing the efficacy of imaging techniques in detecting myometrial invasion, cervical involvement and pelvic lymph-nodal metastasis in endometrial cancer
Abstract
Aim: To compare sensitivity, specificity, positive predictive and negative predictive value of
preoperative imaging techniques for detecting myometrial invasion, cervix involvement, and alsopelvic
lymph nodal metastasis in endometrial cancer
Materials and Methods: The medical records of patients who underwent an operation for endometrial
cancer in the years between 2005 and 2017 were collected from the database at our institution.
Preoperative imaging reports of 252 ultrasonography (USG), 89 computerized tomographies (CT),147
magnetic resonance imaging (MRI) of patients with endometrial cancer, and postoperative pathologic
reports were collected and compared.
Results: In our study 252 ultrasonography (USG), 89 computerized tomography (CT), 147 magnetic
resonance imaging (MRI) examinations were evaluated. Among deep myometrial invasion; all imaging
modalities have low specificities (respectively 26.7%, 37.9%, and 32.4%) but higher sensitivities
(respectively 68.5%, 79.1%, and 89.4%). To rule out cervical invasion all modalities have high and
comparable sensitivities (respectively 98.3%, 95.0%, and 87.0%). On the other hand, USG has
superiority to detect cervical invasion over CT and MRI (respectively 71.4%, 15.4%, and 22.7%). CT
has much highersensitivity than MRI for detection of pelvic lymph node metastasis (87.5% vs 53.1%).
Conclusion: Preoperative imaging modalities have high sensitivities for deep myometrial invasion, but
low detection rates for cervical involvement and pelvic lymph node metastasis. MRI should be the
preferred modality for myometrial invasion, on the other hand, The USG is much better to detect
cervical involvement. CT has superiority on other imaging modalities among lymph node metastasis.
Keywords
References
- Kinkel K et al. Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology. 1999 Sep; 212 (3): 711-8.
- Boronow RC, Morrow CP, Creasman WT, et al. Surgical staging in endometrial cancer: clinical- pathologic findings of a prospective study. Obstet Gynecol 1984; 63:825-832.
- Morrow CP, Curtin JP, Townsend DG, Tumors of the endometrium. In: Morrow CP, Curtin JP,eds.Synopsis of gynecologic oncology.5 th ed. New York, NY: Churchill Livingstone, 1998:151-185.
- Larson DM, Connor GP, Broste SK, Krawisz BR. Johnson KK. Prognostic significance of gross myometrial invasion with endometrial cancer. Obstet Gynecol 1996;88: 394- 398.
- Kodama S. Kase H. Tanaka K. Matsui K. Multivariate analysis of prognostic factors in patients with endometrial cancer. Int. J Gynaecol Obstet 1996: 53:23-30
- Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009; 105(2): 103–104, indexed in Pubmed: 19367689.
- Alcázar JL1, Gastón B2, Navarro B3, Salas R4, Aranda J5, Guerriero S6. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis.J Gynecol Oncol. 2017 Nov;28(6): e86.
- Savelli L1, Ceccarini M, Ludovisi M, Fruscella E, De Iaco PA, Salizzoni E, Mabrouk M, Manfredi R, Testa AC, Ferrandina G.Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging.Ultrasound Obstet Gynecol. 2008 May;31(5):560-6.
- Ingfrid S. Haldorsen, Helga B. Salvesen. What is the Best Preoperative Imaging for EndometrialCancer? Curr Oncol Rep 2016 Apr; 18(4):25.
Endometriyal kanserde myometrial invazyon, servikal invazyon ve pelvik lenf nodu metastazını belirlemede görüntüleme tekniklerinin etkinliğinin karşılaştırılması
Abstract
Amaç: Endometriyal kanserde miyometrial invazyon, serviks tutulumu ve ayrıca pelvik lenf nodu metastazını saptamak için preoperatif görüntüleme tekniklerinin duyarlılık, özgüllük, pozitif prediktif ve negatif prediktif değerini karşılaştırmaktır.
Gereç ve Yöntem: 2005-2017 yılları arasında endometrium kanseri nedeniyle ameliyat olan hastaların tıbbi kayıtları kurumumuzun veri tabanından toplanmıştır. Endometrium kanserli hastaların 252 ultrasonografisi (USG), 89 bilgisayarlı tomografisi (BT), 147 manyetik rezonans görüntülemesi (MRG) ve ameliyat sonrası patolojik raporları toplandı ve karşılaştırıldı.
Bulgular: Çalışmamızda 252 ultrasonografi (USG), 89 bilgisayarlı tomografi (BT), 147 manyetik rezonans görüntüleme (MRG) incelemeleri değerlendirildi. Derin myometrial invazyon arasında; tüm görüntüleme yöntemlerinin özgüllüğü düşük (sırasıyla %26,7, %37,9, %32,4) ancak daha yüksek duyarlılıkları (sırasıyla %68,5, %79,1, %89,4) vardır. Servikal invazyonu dışlamak için tüm modaliteler yüksek ve karşılaştırılabilir hassasiyetlere sahiptir (sırasıyla %98,3, %95,0, %87,0). USG ise BT ve MRG'ye göre servikal invazyonu saptamada üstünlüğe sahiptir (sırasıyla %71,4, %15,4, %22,7). BT, pelvik lenf nodu metastazının saptanması için MRG'den çok daha yüksek duyarlılığa sahiptir (%87,5'e karşı %53,1).
Sonuç: Preoperatif görüntüleme yöntemleri, derin myometrial invazyon için yüksek hassasiyete sahiptir, ancak servikal tutulum ve pelvik lenf nodu metastazı için düşük tespit oranlarına sahiptir. Myometrial invazyon için MRG tercih edilmelidir, öte yandan USG servikal tutulumu saptamak için çok daha iyidir. BT'nin lenf nodu metastazları arasında diğer görüntüleme yöntemlerine üstünlüğü vardır.
Keywords
endometrial kanser görüntüleme teknikleri ultrason manyetil rezonans görüntüleme bilgisayarlı tomografi
Supporting Institution
retrospektif çalışma verileri uludağ üniversitesinden temin edilmiştir
References
- Kinkel K et al. Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology. 1999 Sep; 212 (3): 711-8.
- Boronow RC, Morrow CP, Creasman WT, et al. Surgical staging in endometrial cancer: clinical- pathologic findings of a prospective study. Obstet Gynecol 1984; 63:825-832.
- Morrow CP, Curtin JP, Townsend DG, Tumors of the endometrium. In: Morrow CP, Curtin JP,eds.Synopsis of gynecologic oncology.5 th ed. New York, NY: Churchill Livingstone, 1998:151-185.
- Larson DM, Connor GP, Broste SK, Krawisz BR. Johnson KK. Prognostic significance of gross myometrial invasion with endometrial cancer. Obstet Gynecol 1996;88: 394- 398.
- Kodama S. Kase H. Tanaka K. Matsui K. Multivariate analysis of prognostic factors in patients with endometrial cancer. Int. J Gynaecol Obstet 1996: 53:23-30
- Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009; 105(2): 103–104, indexed in Pubmed: 19367689.
- Alcázar JL1, Gastón B2, Navarro B3, Salas R4, Aranda J5, Guerriero S6. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis.J Gynecol Oncol. 2017 Nov;28(6): e86.
- Savelli L1, Ceccarini M, Ludovisi M, Fruscella E, De Iaco PA, Salizzoni E, Mabrouk M, Manfredi R, Testa AC, Ferrandina G.Preoperative local staging of endometrial cancer: transvaginal sonography vs. magnetic resonance imaging.Ultrasound Obstet Gynecol. 2008 May;31(5):560-6.
- Ingfrid S. Haldorsen, Helga B. Salvesen. What is the Best Preoperative Imaging for EndometrialCancer? Curr Oncol Rep 2016 Apr; 18(4):25.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 12, 2022 |
| Submission Date | May 23, 2022 |
| Published in Issue | Year 2022Volume: 61 Issue: 4 |
