Prognostic Value of Quantitative Perfusion Parameters by Enhanced Ultrasound in Endometrial Cancer

Abstract

BackgroundTumor perfusion is significantly associated with the development and aggressiveness of endometrial cancer. The aim of this study was to assess the prognostic value of quantitative perfusion parameters measured by contrast-enhanced ultrasonography (CEUS) in endometrial cancer before surgery.Material/MethodsA total of 223 patients with endometrial cancer were included between 1 May 1 2013 and 1 May 1 2017 for preoperative CEUS. The mean enhancement rate (ER) was calculated as enhancement intensity (EI)/rise time (RT) results from time-intensity curve (TIC) during CEUS. After a mean follow-up of 33.5±9.9 months, the correlation of ER and postoperative overall survival (OS) and disease-free survival (DFS) was analyzed using univariate and multivariate analysis.ResultsThe optimal cutoff ER value predicting survival based on the ROC curve was 1.8 dB/s. Kaplan-Meier univariate analysis demonstrated that a patient with a high ER level had worse DFS and OS than those with a low ER (DFS, P<0.01; OS, P<0.05). In multivariate analysis, ER was confirmed as an independent predictor for both recurrence (HR, 1.68; 95% CI: 1.01–7.73) and OS (HR, 1.98; 95%CI: 1.01–7.83) for patients with endometrial cancer (both P<0.05).ConclusionsPerfusion variables measured by CEUS are significantly useful predictive factor for postoperative survival in endometrial cancer.

Contrast-Enhanced Ultrasound Imaging of Uterine Disorders: A Systematic Review

“…21 Finally, the perfusion parameter “enhancement rate” (dB/s) determined pre-operatively was shown to be an independent predictor for both recurrence of endometrial carcinoma (hazard ratio 1.7; 95% CI 1.0–7.7; p < .05) and overall survival (hazard ratio 2.0; 95% CI 1.0–7.8; p < .05) in a retrospective study with 223 patients. 24…”

“…Endometrial carcinoma is the most common gynecological malignancy. 18 This is reflected in the higher number of studies evaluating CEUS for this malignancy: one case-control 17 and seven prospective cohort studies, 18,[20][21][22][23][24][25] with histology-proven endometrial carcinoma. These studies did show different enhancement patterns between malignant and healthy tissue.…”

“…The average accuracy of CEUS as diagnostic tool for staging endometrial carcinoma is 81%, with an average sensitivity of 0.78 and specificity of 0.81. 17,18,[20][21][22][23][24][25] The numbers of the individual studies are shown in Table 3. The additional value of combined 2D-and 3D-CEUS imaging (diagnostic accuracy 84%) over 2D-CEUS alone (diagnostic accuracy 75%) was demonstrated in 68 patients with clinically suspected endometrial carcinoma, of which 26 cases were confirmed by histology.…”

Clinical Value Analysis of Combined Vaginal Ultrasound, Magnetic Resonance Dispersion Weighted Imaging, and Multilayer Spiral CT in the Diagnosis of Endometrial Cancer Using Deep VGG-16 AdaBoost Hybrid Classifier

“…Gaussian Markov generalized additive noise reduction may be achieved by altering the kernel of the classic adaptive WF. In [ 21 ] approach to preserve edge and detail while reducing noise, the target contained in the noise is provided by the reference target. …”