VP66.02: 3D ultrasound for preoperatively staging endometrial cancer

Abstract

An article was recently published in Obstetrics and Gynecology, comparing available strategies to determine the optimal methodology to employ when deciding on whether to perform a pelvic lymphadenectomy (PL) in conjunction with a hysterectomy for the treatment of Endometrial Carcinoma (EC). Though this investigation was published a few years ago (the citation is listed below), the case series was continued to the present day. All patients in this investigation who were clinically diagnosed with EC were examined sonographically prior to scheduled surgery, using 3DTVS and power Doppler angiography (PDA), and Virtual Organ Computer-Aided Analysis (VOCAL) and Volume Contrast Imaging (VCI) from April, 2015 through March, 2020. All patients underwent a subsequent surgical procedure with the resulting surgical histology obtained within three months after the TVS, to be compared with those pre-operative ultrasound findings. Deep myometrial infiltration was diagnosed when the tumour was equal or more than 50% of the total thickness of the uterine wall. The identified sonographic features of the patients enrolled in this study were compared with the intraoperative and post-operative pathologic findings. With the results of the analysis of 27 patients, the sonographic findings predicted the minimum EC staging 100 % of the time. There may be some benefit to knowing the extent of myometrial invasion at the time of hysterectomy, so as to best decide on whether to perform a PL. In this case series, the authors correctly predicted the pathologic EC staging 100% of the time with pre-operative 3DTVS, which should be strongly considered for its routine pre-surgical use when the diagnosis of EC is being considered. REFERENCE 1. Fernandez CM, Levine EM, Dini M, Bannon K, Butler S, LocherS: Predictive value of three-dimensional transvaginal sonographyfor staging of endometrial carcinoma. J Diagn Med Sonogr2018; 34(5): 496-500.