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Ultraschall Med 2023; 44(03): 280-289
DOI: 10.1055/a-1408-2292
Review

Preoperative Assessment of Cervical Involvement in Endometrial Cancer by Transvaginal Ultrasound and Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis

Präoperative Bewertung der Zervixbeteiligung bei Endometriumkarzinom mittels transvaginalen Ultraschalls und Magnetresonanztomografie: Ein systematischer Review und Metaanalyse
Juan Luis Alcazar 
1   Obstetrics and Gynecology, University of Navarra Clinic, Pamplona, Spain
,
Patricia Carazo
2   Obstetrics and Gynecology, University Hospital Complex Badajoz, Spain
,
Leyre Pegenaute
3   Obstetrics and Gynecology, Araba University Hospital Txagorritxu Campus, Vitoria-Gasteiz, Spain
,
Elena Gurrea
4   Obstetrics and Gynecology, Virgen de la Arrixaca University Hospital, El Palmar, Spain
,
Irene Campos
4   Obstetrics and Gynecology, Virgen de la Arrixaca University Hospital, El Palmar, Spain
,
Manuela Neri
5   Obstetrics and Gynecology, Università degli Studi di Cagliari, Italy
,
Maria Angela Pascual 
6   Obstetrics and Gynecology, Institut Universitari Dexeus, Barcelona, Spain
,
Stefano Guerriero 
5   Obstetrics and Gynecology, Università degli Studi di Cagliari, Italy
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Abstract

Objective To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting cervical infiltration by endometrial carcinoma using meta-analysis assessment.

Methods An extensive search of papers comparing TVS and MRI for assessing cervical infiltration in endometrial cancer in the same set of patients was performed in Medline (Pubmed), Web of Science, and the Cochrane Database. Quality was assessed using QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies-2). Quantitative meta-analysis was performed.

Results Our extended search identified 12 articles that used both techniques in the same set of patients and were included in the meta-analysis. The risk of bias for most studies was high for patient selection and index tests in QUADAS-2. Overall, the pooled estimated sensitivity and specificity for diagnosing cervical infiltration in women with endometrial cancer were identical for both techniques [69 % (95 % CI, 51 %–82 %) and 93 % (95 % CI, 90 %–95 %) for TVS, and 69 % (95 % CI, 57 %–79 %) and 91 % (95 % CI, 90 %–95 %) for MRI, respectively]. No statistical differences were found when comparing both methods. Heterogeneity was high for sensitivity and moderate for specificity when analyzing TVS and moderate for both sensitivity and specificity in the case of MRI.

Conclusion TVS and MRI showed very similar diagnostic performance for diagnosing cervical involvement in women with endometrial cancer.

Zusammenfassung

Ziel Vergleich der diagnostischen Genauigkeit des transvaginalen Ultraschalls (TVS) und der Magnetresonanztomografie (MRT) zum Nachweis einer Zervixbeteiligung bei Endometriumkarzinom mittels Metaanalyse.

Methoden In Medline (PubMed), Web of Science und der Cochrane-Datenbank wurde eine umfassende Suche nach Artikeln durchgeführt, in denen TVS und MRT hinsichtlich der Bewertung der zervikalen Infiltration in der gleichen Patientengruppe verglichen wurden. Die Qualität wurde mit dem QUADAS-2-Tool (Quality Assessment of Diagnostic Accuracy Studies-2) bewertet. Eine quantitative Metaanalyse wurde durchgeführt.

Ergebnisse Unsere erweiterte Suche identifizierte 12 Artikel, die beide Techniken bei der gleichen Patientengruppe anwendeten und in die Metaanalyse aufgenommen wurden. Das Biasrisiko war in den meisten Studien für die Patientenauswahl und die Index-Tests in QUADAS-2 hoch. Insgesamt waren die gepoolte geschätzte Sensitivität und Spezifität für die Diagnose einer zervikalen Infiltration bei Frauen mit Endometriumkarzinom für beide Techniken identisch (69 % (95 %-KI 51–82 %) und 93 % (95 %-KI 90–95 %) für TVS bzw. 69 % (95 %-KI 57–79 %) und 91 % (95 %-KI 90–95 %) für MRT). Beim Vergleich der beiden Methoden wurden keine statistischen Unterschiede festgestellt. Die Heterogenität war hoch für die Sensitivität und moderat für die Spezifität bei der TVS und moderat sowohl für die Sensitivität als auch für die Spezifität bei der MRT.

Schlussfolgerung TVS und MRT zeigten eine sehr ähnliche diagnostische Leistung für die Diagnose einer Zervixbeteiligung bei Frauen mit Endometriumkarzinom.

Key words

endometrial cancer - ultrasound - MRI - cervical infiltration - gynecology


Publication History

Received: 29 October 2020

Accepted: 09 February 2021

Article published online:
23 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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