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Objective@#This study aimed to compare the diagnostic accuracy of gynecologic oncology ultrasound and magnetic resonance imaging (MRI) in the assessment of early-stage cervical cancer.@*Methodology@#This was a prospective, cross-sectional study of patients with early-stage cervical cancer eligible for radical hysterectomy in a tertiary government institution from November 25, 2020, to August 2, 2022. Preoperative gynecologic oncology (transabdominal/transvaginal/transrectal) ultrasound and MRI measurements were obtained and compared with histopathologic findings. Sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio were used to check for the diagnostic accuracy of each modality.@*Results@#A total of 27 patients were enrolled in the study. Four were stage IB1 (14.81%), 10 were stage IB2 (37.03%), nine were stage IB3 (33.33%), two were stage IIA1 (7.40%), and two were stage IIA2 (7.40%). Ultrasound has a comparable diagnostic accuracy with MRI to assess tumor size length, width, and height with an area under the curve of 0.789, 0.753, and 0.806, respectively. Both modalities can predict the absence of parametrial invasion and nodal involvement with a specificity of 100% and a negative predictive value of 88.89% and 81.48%, respectively. The results of the gynecologic oncology ultrasound showed good agreement with MRI.@*Conclusion@#Ultrasound has comparable diagnostic accuracy with MRI in assessing tumor size, parametrial invasion, and nodal involvement in patients with early-stage cervical cancer. It is a good alternative imaging modality to MRI in staging cervical cancer, especially in low- to middle-income countries.
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Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: Transvaginal sonography with Doppler study has helped improve the clinician's ability to diagnose and manage intrauterine abnormalities. Use of International Endometrial Tumor Analysis (IETA) may help predict the risk of endometrial pathologies based on ultrasound appearance.OBJECTIVE: To determine the accuracy of 2D ultrasound and power Doppler in the examination of the endometrium using the international endometrial tumor analysis classification in predicting intrauterine disease among patients with endometrial pathology in Dr. Jose Fabella Memorial Hospital.STUDY DESIGN: A cross-sectional study was done on patients who were diagnosed with abnormal uterine bleeding and underwent 2D ultrasound and power Doppler studies. Sonographic features were classified using International Endometrial Tumor Analysis group classification and correlated with the histopathologic diagnosis.RESULTS: Seventy-three patients were included in the study. The age of the subjects was significantly associated with the the histopathologic findings of benignity or malignancy. At 40-49 years old, there was significantly higher proportion of subjects with benign lesions, and 60 years and above had predominance of malignancy. The top three histopathologic diagnoses: endometrial polyp 41 cases (46.2%), proliferative endometrium 9 cases (12.3%), and simple hyperplasia without atypia 8 cases (11.0%). Patients diagnosed with malignancy had significantly thickened endometrium at 2.9 cm. The color content of the endometrium (color score) were statistically significant among different pathologies. Positive predictive value is the same for both, while Doppler showed a higher negative predictive value. Total accuracy was higher for Doppler.CONCLUSION: Both greyscale ultrasound and Doppler are 100% accurate in predicting benign lesions but Doppler has a higher accuracy in predicting malignant lesions. The IETA group consensus on descriptive and morphologic nomenclature in describing endometrial findings for power Doppler and on greyscale ultrasound is clinically valuable.