title: Preoperative assessment of endometrial carcinoma by three-dimensional power Doppler angiography.
abstract: OBJECTIVE
  Preoperative evaluation of the depth of myometrial invasion in endometrial carcinoma is challenging. The objective of this study was to evaluate the usefulness of three-dimensional power Doppler angiography (3D-PDA) in this setting.
  
  
  METHODS
  Sonographic and histological data on 100 consecutive cases of endometrial carcinoma were analyzed. The endometrial and myometrial vascular indices VI (vascularization index), FI (flow index) and VFI (vascularization flow index) were calculated by 3D-PDA. The results were compared with a complete surgical staging.
  
  
  RESULTS
  The mean ( ± SD) age of patients was 67.1 ± 8.8 (range, 33-87) years. Forty-six patients had deep (≥ 50%) myometrial invasion. Eight patients had metastases, seven of them with deep invasion. Three patients were found to have carcinomas of non-uterine origin on histology, and these were excluded from further statistical analysis. The median endometrial and myometrial vascular indices were higher in the group with deep invasion than in the group without. Following multivariable analysis of the indices only the endometrial FI was independently associated with deep invasion (OR, 1.061; 95% CI, 1.023-1.099; P = 0.001). However, a greater endometrial volume was also an independent predictor of deep invasion (OR, 1.109; 95% CI, 1.011-1.215; P = 0.028).
  
  
  CONCLUSIONS
  Our study suggests that endometrial and, to a lesser degree, myometrial vascular indices and endometrial volume correlate with the depth of myometrial invasion in endometrial carcinoma.
authors.affiliation: Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.
authors.forename: S K
authors.initials: SK
authors.lastname: Saarelainen
authors.forename: M H
authors.initials: MH
authors.lastname: Vuento
authors.forename: P
authors.initials: P
authors.lastname: Kirkinen
authors.forename: J U
authors.initials: JU
authors.lastname: Mäenpää
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001783:Blood Flow Velocity; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000295:instrumentation / Q000379:methods*; D014463:Ultrasonography; D014655:Vascular Resistance