title: Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma by transvaginal ultrasound.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of transvaginal ultrasound (TVS) in preoperative assessment of the depth of myometrial infiltration and the presence of cervical invasion in endometrial carcinoma.
  
  
  METHODS
  298 consecutive patients with a diagnosis of endometrial cancer were evaluated by TVS within 3 days of surgical intervention. The depth of myometrial invasion was classified into two groups: no or <50% invasion and ≥50% invasion. Invasion of cervix was diagnosed when the neoplastic tissue distended the cervix and showed ill-defined borders with the cervical stroma.
  
  
  RESULTS
  The sensitivity, specifity, positive predictive value (PPV), negative predictive value (NPV) and overall diagnostic accuracy of TVS in evaluation of the depth of myometrial infiltration were 68.4%, 82%, 65.1%, 84.1% and 77.5%, respectively. While the sensitivity and PPV were significantly higher among grade 3 tumors, the specifity, NPV and accuracy were significantly higher among grade 1 tumors. The sensitivity, specifity, PPV, NPV, and overall diagnostic accuracy of TVS in assessment of the presence or absence of neoplastic tissue in cervix were 76.5%, 99.3%, 86.7%, 98.2% and 98%, respectively. While the sensitivity and PPV were significantly higher among grade 1 tumors, the NPV and accuracy were significantly lower among grade 3 tumors.
  
  
  CONCLUSIONS
  TVS can be considered as a feasible, economical and simple imaging modality with a high diagnostic accuracy for the prediction of cervical involvement. However, it is not a reliable method in estimating the depth of myometrial infiltration.
authors.affiliation: Bakirkoy Women's and Children's Teaching Hospital, Department of Obstetrics and Gynecology, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akbayir
authors.forename: Aytul
authors.initials: A
authors.lastname: Corbacioglu
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Numanoglu
authors.forename: Filiz Yarsilikal
authors.initials: FY
authors.lastname: Guleroglu
authors.forename: Volkan
authors.initials: V
authors.lastname: Ulker
authors.forename: Alparslan
authors.initials: A
authors.lastname: Akyol
authors.forename: Birgul
authors.initials: B
authors.lastname: Guraslan
authors.forename: Engin
authors.initials: E
authors.lastname: Odabasi
mesh_terms: D002584:Cervix Uteri / Q000000981:diagnostic imaging* / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D009361:Neoplasm Invasiveness; D011300:Preoperative Care; D012189:Retrospective Studies; D014463:Ultrasonography