J Gynecol Oncol.  2017 Nov;28(6):e86. 10.3802/jgo.2017.28.e86.

Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis

• Alcázar J
• Gastón B
• Navarro B
• Salas R
• Aranda J
• Guerriero

• KMID: 2413212
• DOI: http://doi.org/10.3802/jgo.2017.28.e86

Abstract

OBJECTIVE
To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting myometrial infiltration (MI) in endometrial carcinoma.
METHODS
An extensive search of papers comparing TVS and MRI in assessing MI in endometrial cancer was performed in MEDLINE (PubMed), Web of Science, and Cochrane Database from January 1989 to January 2017. Quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
RESULTS
Our extended search identified 747 citations but after exclusions we finally included in the meta-analysis 8 articles. The risk of bias for most studies was low for most 4 domains assessed in QUADAS-2. Overall, pooled estimated sensitivity and specificity for diagnosing deep MI were 75% (95% confidence interval [CI]=67%-82%) and 82% (95% CI=75%-93%) for TVS, and 83% (95% CI=76%-89%) and 82% (95% CI=72%-89%) for MRI, respectively. No statistical differences were found when comparing both methods (p=0.314). Heterogeneity was low for sensitivity and high for specificity for TVS and MRI.
CONCLUSION
MRI showed a better sensitivity than TVS for detecting deep MI in women with endometrial cancer. However, the difference observed was not statistically significant.

Keyword

Endometrial Neoplasms; Myometrium; Infiltration; Ultrasound; Transvaginal; Magnetic Resonance Imaging

MeSH Terms

Endometrial Neoplasms/*diagnostic imaging/pathology
Female
Humans
*Magnetic Resonance Imaging
Myometrium/*diagnostic imaging/pathology
Neoplasm Invasiveness
Preoperative Care
Sensitivity and Specificity
*Ultrasonography
Vagina