title: Three-dimensional transvaginal ultrasonography for locally advanced cervical cancer.
abstract: OBJECTIVE
  The aim of the study was to evaluate the feasibility of using 3-dimensional transvaginal ultrasound (3D-TVUS) to diagnose the extent of invasive cervical cancer.
  
  
  METHODS
  Using 3D-TVUS, we prospectively examined 24 patients diagnosed with locally advanced invasive cervical cancer before primary surgery. Parametrial, vaginal, bladder, and rectal invasion, alongside cancer staging, was evaluated in the orthogonal planes. We compared the preoperative clinical, magnetic resonance imaging (MRI), and ultrasonography findings with the histological results from surgery.
  
  
  RESULTS
  With respect to cancer staging, accuracy was 62.5% with clinical examination, 40.9% with MRI, and 66.7% with TVUS. Magnetic resonance imaging demonstrated both low specificity (64.3%) and accuracy (68.2%) for nodal involvement. For the detection of parametrial invasion: sensitivity was 25% with clinical exanimation, 75% with MRI, and 75% with TVUS; specificity was 55.6% with MRI and 90% with TVUS; accuracy was 59% with MRI and 87.5% with TVUS. Although there was no case with bladder or rectal invasion, TVUS and MRI showed high specificity for the assessment of these. Clinical examination was useful for the detection of vaginal involvement.
  
  
  CONCLUSIONS
  Preoperative 3D-TVUS may prove to be an excellent method for the evaluation of locally advanced cervical cancer. Transvaginal ultrasound also has advantages over MRI for the assessment of tumor volume and Doppler velocimetry and is a low-cost alternative. However, TVUS cannot identify nodal or distant metastasis.
authors.affiliation: *Department of Obstetrics and Gynecology and †Paik Institute for Clinical Research, College of Medicine, Inje University, Busan Paik Hospital, Busan, Korea.
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Byun
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Kim
authors.forename: Dae Hoon
authors.initials: DH
authors.lastname: Jeong
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kim
authors.forename: Moon Su
authors.initials: MS
authors.lastname: Sung
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D002584:Cervix Uteri / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014625:Vaginal Neoplasms / Q000556:secondary