The evaluation of endometrial tumors by transvaginal and Doppler ultrasonography

Endometrial cancer is the most common malignancy of the female genital tractus which is primarily seen in postmenopausal women. The purpose of this study is to investigate the relation between uterine histopathologic alterations and sonographic findings in women diagnosed with endometrial cancer.

A total of 120 women who were histologically diagnosed with endometrial cancer and who admitted to Gynecologic Oncology Department in the study center were eligible. The subjects were evaluated by Doppler ultrasonography (USG) coupled with a vaginal probe before surgery. After surgical staging was performed in all participants, the preoperative sonographic findings were compared with histopathologic information yielded from surgical specimens.

The mean age of the study population was 53.1 years. About 85% of the subjects were postmenopausal. The mean endometrial thickness measured by transvaginal USG was found to be 25.6 +/- 13.4 mm (range 6-88 mm). The diagnostic accuracy, sensitivity, specificity, positive and negative predictive values of transvaginal USG was, respectively, 69, 66, 72, 60 and 75%. In 37 (30.8%) patients, transvaginal USG could not correctly predict the depth of myometrial invasion. Myometrial invasion was underestimated in 17 cases (14.2%) and overestimated in 20 cases (16.7%). There was a significant negative correlation between the tumor grade and uterine artery blood flow.

The results of the present study determine that transvaginal USG has moderate sensitivity and moderate-to-high specificity which limit its use. However, endometrial thickness, myometrial invasion and resistance index values determined by Doppler USG can indicate the tumor grade allowing individualized treatment to be planned for endometrial tumors.