EP29.09: Preoperative power Doppler score in predicting depth of myometrial invasion in endometrioid type of endometrial carcinoma

Abstract

Our aim is to explore the role of transvaginal power Doppler score and vascular flow pattern to discriminate superficial and deep myometrial invasion in cases of endometrial carcinoma in order to allow preoperative surgical planning and to identify those patients who would benefit from staging lymphadenectomy. Retrospective analysis of 123 preoperative ultrasounds in endometrioid type of endometrial carcinoma. We analysed 66 studies in women with histopathology proven myometrial infiltration of ≤50% and 57 patients with ≥50%. 2D power Doppler scoring was carried out according to the International Ovarian Tumour Analysis (IOTA) for adnexal mass and used by the Endometrial Tumour Analysis (IETA) group to endometrial assessment. A score of 1 (no colour flow sign) and 2 (minimal colour sign) were considered a low risk indicator. Score 3 (moderate colour) and 4 (abundant colour) were considered a high risk indicator. In 123 women (mean age, 59.2 years; range, 54–86 years) with endometrioid type of endometrial cancer were included in the study. A high risk indicator (colour score 3-4) was found in 9 patients out of 66 (13.6%) who had myometrial invasion of less than 50% and 11 out of 57 patients (19.2%) in more than 50%. The low risk indicator on Doppler flow analysis demonstrated 58 (87.8%) cases with less than 50% myometrial invasion. A colour score of 2 was the most frequently encountered in this group. The most common vascular flow pattern was multiple vessels with multiple origins. The most common vascular pattern was multiple dominant vessels with multifocal origins. Exploratory analysis of Power Doppler demonstrated poor correlation with limited role in predicting grade of depth myometrial invasion in cases of endometrioid type of endometrial carcinoma. Low risk indicator may correlate better identifying tumour with invasion of less than 50% of myometrium.