Accuracy of the preoperative assessment of myometrial invasion with transvaginal ultrasound

Background: Myometrial invasion (MI) is an important prognostic factor in endometrial cancer. This study aimed to evaluate the diagnostic accuracy of transvaginal ultrasound (TVUS) in predicting preoperative MI compared to the postoperative histopathological diagnosis in clinical practice. Furthermore, we aimed to explore how comparable the accuracy of TVUS is between non-obese and obese patients. Methods: This was a hospital-based retrospective analysis of clinical data on patients with endometrioid endometrial cancer who were operatively treated between January 2019 and December 2020. Results: The final cohort size was 114 patients. Preoperative TVUS had 79.8%accuracy, 68.4% sensitivity, and 85.5% specificity in predicting MI. It was an even better MI predictor in patients with a higher body mass index (BMI; >30 kg/m2), with 84.2% accuracy, 80.0% sensitivity and 86.5% specificity. Moreover, the positive likelihood ratio is better among obese than non-obese patients. Conclusions: TVUS is an inexpensive and feasible method for assessing preoperative MI, especially in patients with a higher BMI.

Endometrial cancer; Myometrial invasion; Transvaginal ultrasound

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