Abstract
To evaluate the diagnostic accuracy of TVUS in the preoperative detection of deep myometrial infiltration (MI) in patients with endometrial cancer (EC), using the surgical-pathologic data as a reference standard. An extensive search was performed in Medline (Pubmed) and EMBASE from January 1989 to January 2015. Quality was assessed using QUADAS-2 tool. Our extended search identified 184 citations but we finally examined the full text of the 30 articles. Overall pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of TVS for detecting deep myometrial infiltration was 82% (95% CI, 76–87%), 81% (95% CI, 76–85%), respectively. We did not observe differences among all three methods in terms of diagnostic performance. Significant heterogeneity was found for sensitivity and specificity for all three methods (I2 values ranging from 60.57 to 94.96). Overall diagnostic performance of TVS for detecting deep myometrial infiltration in women with endometrial cancer is acceptable. However, more studies with improved quality in design and using TVUS only in low risk cases and comparing several approaches in the same set of women are needed.
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