A Comparative Study of Transvaginal Sonography and Pelvic MRI in Patients with Endometrial Cancer

Abstract

Background: The most prevalent type of gynecological cancer is endometrial cancer. Accurate surgical staging is the most important aspect in the management of endometrial cancer. Preoperative evaluation of myometrial invasion and appropriate management could be achieved by transvaginal sonography and pelvic MRI. Methods: A total of 53 patients with endometrial cancer, who were referred to a gynecology oncology department of an academic hospital in Mashhad University of Medical Sciences from 2018 to 2020, were evaluated in this study. Data were collected using a questionnaire on endometrial cancer. All the patients underwent preoperative transvaginal sonography and pelvic MRI to evaluate myometrial invasion. The involvement of myometrium thickness and histological findings were compared between two imaging modalities, and SPSS 23.0 was used to analyze the data. Results: Junctional irregularity was the most prevalent finding on transvaginal sonography. Based on transvaginal sonography, myometrial invasion of less than 50% was found in 73% of patients, while invasion of more than 50% was observed in 26.31%. In 57.44% of MRIs, there was less than 50% myometrial invasion, while in 42.55% of MRIs, there was more than 50% myometrial invasion. In both modalities, the most common finding was myometrial invasion of less than 50%. The accuracy, sensitivity, and specificity of transvaginal sonography were 0.47, 0.27, and 0.75, respectively, whereas the accuracy, sensitivity, and specificity of MRI were 0.54, 0.45, and 0.61, respectively. Conclusion: MRI can be the modality of choice for evaluating myometrial invasion and optimizing endometrial cancer treatment planning, as well as reducing the complications of non-indicated lymphadenectomy.