OC24.05: The role of ultrasound in planning fertility sparing surgery and individual treatment in early stage cervical cancer

Abstract

Radiologists provided diagnosis of parametrial infiltration at MR for the same sections. Infiltration was classified as Grade 1 or ‘‘incipient’’(the tumor infiltrates the pericervical fascia) and Grade 2–3 or ‘‘evident’’(the infiltration progresses through the fascia to the parametrium). Concordance between 2D-US, 3D-US, and MR results was assessed. Results: Agreement between 2D-US, 3D-US, and MRI was 65%. Agreement between MR and 2D-US was 76%; agreement between 3D-US and MR was 79%. In all discordant cases with no parametrial infiltration at MR, Grade 1 infiltration was diagnosed at 3D-US; in no case 3D-US underestimated MR results. When considering agreement between 3D-US and MR for each section, the best concordance was achieved in intermediate space (76%), and the worst in caudal space (34.5%). Conclusions: Off-line analysis of 3D-US seems to be an accurate diagnostic tool in assessment of parametrial infiltration, with comparable results to MR in all cases with evident infiltration. Dynamic evaluation at 2D-US, and a continuous scrolling through the cervix at 3D-US off-line analysis represent two advantages of US examination.