Predictability of myometrial, lower uterine segment and cervical invasion with 3D transvaginal ultrasonography and magnetic resonance imaging in endometrial cancer patients: a prospective cohort study

Aims: The objective of this study is to identify the diagnostic performance of three-dimensional transvaginal ultrasonography (3D-US) and magnetic resonance imaging (MRI) in detecting myometrial, lower uterine segment and/or cervical invasion in endometrial cancer patients. Materials and methods: In this prospective study, 40 patients diagnosed with endometrial cancer were performed 3D-US and MRI, preoperatively. Deep myometrial, lower uterine segment and cervical invasion were evaluated subjectively and results were compared with the final histology as a gold standard. Results: Diagnostic accuracy of 3D-US for detecting deep myometrial, lower uterine segment and cervical invasion were 87.5%, 80% and 85%, respectively. The same results for MRI were 75%, 65% and 70%, respectively. For deep myometrial, lower uterine segment and/or cervical invasion in endometrial cancer, 3D-US had higher sensitivity, specificity, negative and positive predictive value and accuracy than MRI. The combination of these two imaging techniques had an increased sensitivity of detecting all parameters related with tumoral invasion but decreased specificity and the accuracy. Conclusion: 3D-US had better performance in detecting myometrial, lower uterine segment and/or cervical invasion than MRI in endometrial cancer patients. Combination of these techniques was not preferred according to this study.