Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Cubo-Abert, Montserrat; Díaz-Feijoó, Berta; Bradbury, Melissa; Rodríguez-Mias, Nuria-Laia; Vera, Marta; Pérez‐Hoyos, S.; Gómez‐Cabeza, J.‐J.

doi:10.1002/uog.23607

Cited by 18 publications

(27 citation statements)

References 34 publications

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“…MI has been evaluated through several imaging modalities, including MR, computed tomography (CT), and ultrasound (US) 10,11 . However, MR has a much higher diagnostic accuracy compared to CT and US 12,13 .…”

Section: Introductionmentioning

confidence: 99%

“…8,9 MI has been evaluated through several imaging modalities, including MR, computed tomography (CT), and ultrasound (US). 10,11 However, MR has a much higher diagnostic accuracy compared to CT and US. 12,13 MR images usually used in the evaluation of endometrial cancer include high-resolution T2-weighted (T2W), diffusionweighted (DW), and dynamic contrast-enhanced (DCE) sequences.…”

Section: Introductionmentioning

confidence: 99%

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Machine Learning‐Based Integration of Prognostic Magnetic Resonance Imaging Biomarkers for Myometrial Invasion Stratification in Endometrial Cancer

Rodríguez-Ortega

Alegre

Lago

et al. 2021

Magnetic Resonance Imaging

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Background Estimation of the depth of myometrial invasion (MI) in endometrial cancer is pivotal in the preoperatively staging. Magnetic resonance (MR) reports suffer from human subjectivity. Multiparametric MR imaging radiomics and parameters may improve the diagnostic accuracy. Purpose To discriminate between patients with MI ≥ 50% using a machine learning‐based model combining texture features and descriptors from preoperatively MR images. Study Type Retrospective. Population One hundred forty‐three women with endometrial cancer were included. The series was split into training (n = 107, 46 with MI ≥ 50%) and test (n = 36, 16 with MI ≥ 50%) cohorts. Field Strength/Sequences Fast spin echo T2‐weighted (T2W), diffusion‐weighted (DW), and T1‐weighted gradient echo dynamic contrast‐enhanced (DCE) sequences were obtained at 1.5 or 3 T magnets. Assessment Tumors were manually segmented slice‐by‐slice. Texture metrics were calculated from T2W and ADC map images. Also, the apparent diffusion coefficient (ADC), wash‐in slope, wash‐out slope, initial area under the curve at 60 sec and at 90 sec, initial slope, time to peak and peak amplitude maps from DCE sequences were obtained as parameters. MR diagnostic models using single‐sequence features and a combination of features and parameters from the three sequences were built to estimate MI using Adaboost methods. The pathological depth of MI was used as gold standard. Statistical Test Area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, precision and recall were computed to assess the Adaboost models performance. Results The diagnostic model based on the features and parameters combination showed the best performance to depict patient with MI ≥ 50% in the test cohort (accuracy = 86.1% and AUROC = 87.1%). The rest of diagnostic models showed a worse accuracy (accuracy = 41.67%–63.89% and AUROC = 41.43%–63.13%). Data Conclusion The model combining the texture features from T2W and ADC map images with the semi‐quantitative parameters from DW and DCE series allow the preoperative estimation of myometrial invasion. Evidence Level 4 Technical Efficacy Stage 3

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Machine Learning‐Based Integration of Prognostic Magnetic Resonance Imaging Biomarkers for Myometrial Invasion Stratification in Endometrial Cancer

Rodríguez-Ortega

Alegre

Lago

et al. 2021

Magnetic Resonance Imaging

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“…Cubo-Abert et al obtained similar results as in our study, when it comes to the diagnostic accuracy of TVUS versus MRI in estimating the depth of MI, with the difference that they used the TVUS method based on the measurement of the minimal distance to the uterine serosa. 24 Costas et al in systematic review and metaanalysis have not found a satisfying number of studies about the comparison of 2D-TVUS and 3D-TVUS methods for MI assessment in EC. 25 They have identified lack of knowledge and studies regarding the objective methods used for 3D-TVUS assessment and their comparison with subjective 3D-TVUS methods.…”

Section: Discussionmentioning

confidence: 97%

“…obtained similar results as in our study, when it comes to the diagnostic accuracy of TVUS versus MRI in estimating the depth of MI, with the difference that they used the TVUS method based on the measurement of the minimal distance to the uterine serosa. 24 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study

Cerovac

Ljuca

Arnautalic

et al. 2022

Radiology and Oncology

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Background We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method. Patients and methods Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%). Results Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy. Conclusions We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

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“…They also determine the treatment, as most of the patients with early-stage disease require minimally invasive surgery. The treatment of choice for patients with low-risk stage-T1a endometrial cancer is a total hysterectomy and bilateral salpingo-oophorectomy [ 17 , 22 ]. Patients with greater than 50% myometrial invasion have a six- to seven-fold higher prevalence of pelvic and para-aortic lymph node metastasis than those with less than 50% myometrial invasion [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and T2-Weighted Imaging in Determining the Depth of Myometrial Invasion in Endometrial Carcinoma—A Retrospective Study

Nurdillah

Rizuana

Aziz

et al. 2022

JPM

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This study aims to compare dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with T2-weighted imaging (T2WI) in defining the depth of myometrial invasion in endometrial carcinoma. This retrospective study included 32 subjects with endometrial carcinoma who underwent 3.0T magnetic resonance imaging (MRI) prior to hysterectomy. DCE-MRI and T2WI were evaluated to determine the depth of myometrial invasion in endometrial carcinoma. A set of data consisting of the sensitivity, specificity, predictive values, and accuracy of DCE-MRI and T2WI were obtained and compared with the histopathological results. Out of the 32 cases included, the histopathological examination revealed that 50% myometrial invasion was found in 11 patients and ≥50% myometrial invasion was found in 21 patients. In the assessment of the tumor invasion, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of T2WI were 45.45%, 90.48 %, 71.43%, 76.0%, and 75.0%, respectively. The corresponding values for DCE-MRI were 81.82%, 76.19%, 64.29%, 88.89 %, and 78.12%, respectively. When T2WI were read together with DCE-MRI, the values were 90.91%, 90.48%, 83.33%, 95.0%, and 90.62%, respectively. Thus, the sensitivity and accuracy of DCE-MRI were greater compared to T2WI in defining the depth of myometrial invasion. However, the merging of T2WI and DCE-MRI increased the specificity and PPV value and improved the sensitivity, NPV and accuracy in detecting myometrial invasion. DCE-MRI was more sensitive but less specific than T2WI in defining the depth of myometrial invasion. In conclusion, combining DCE-MRI and T2WI further improves the diagnostic performance for myometrial invasion in endometrial carcinoma.

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Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Cited by 18 publications

References 34 publications

Machine Learning‐Based Integration of Prognostic Magnetic Resonance Imaging Biomarkers for Myometrial Invasion Stratification in Endometrial Cancer

Machine Learning‐Based Integration of Prognostic Magnetic Resonance Imaging Biomarkers for Myometrial Invasion Stratification in Endometrial Cancer

Efficacy of transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial invasion in patients with endometrioid endometrial cancer: a prospective comparative study

A Comparison of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and T2-Weighted Imaging in Determining the Depth of Myometrial Invasion in Endometrial Carcinoma—A Retrospective Study

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