title: Sonohysterography and endometrial cancer: incidence and functional viability of disseminated malignant cells.
abstract: OBJECTIVE
  The purpose of this study was to evaluate sonohysterography in patients with endometrial cancer and to determine whether (1) transtubal fluid spill occurs during routine sonohysterography, (2) a critical infusion volume for spill exists, or (3) disseminated cancer cells demonstrate viability.
  
  
  METHODS
  At laparotomy, sonohysterography was performed on 16 patients with endometrial adenocarcinoma. Volumes at which tubal spill occurred were recorded. Collected specimens were processed and incubated. After evaluation for viable cells, cytologic analysis was undertaken.
  
  
  RESULTS
  The median volume that was required for adequate sonohysterography was 8.5 mL. Five patients (31%) had transtubal spill. With an additional saline solution flush, the median total volume for a spill was 20.5 mL. Two patients (12.5%) had viable benign cells that were cultured after routine sonohysterography. One patient (6%) had nonviable carcinoma cells that were identified.
  
  
  CONCLUSIONS
  Transtubal spill occurs during sonohysterography. No critical spill volume was identified. A highly diagnostic tool when abnormal bleeding is evaluated, sonohysterography has a low probability of cancer cell dissemination.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Berry
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lindheim
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Connor
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Hartenbach
authors.forename: Julian C
authors.initials: JC
authors.lastname: Schink
authors.forename: Josephine
authors.initials: J
authors.lastname: Harter
authors.forename: Jens C
authors.initials: JC
authors.lastname: Eickhoff
authors.forename: David M
authors.initials: DM
authors.lastname: Kushner
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002470:Cell Survival; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D009366:Neoplasm Seeding; D011446:Prospective Studies; D013048:Specimen Handling; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging