Ultrasound Scoring to Predict High-Risk Endometrial Cancer

Area of Science:

• Gynecologic Oncology
• Medical Imaging
• Diagnostic Tools

Background:

• Endometrial cancer risk stratification is crucial for appropriate treatment.
• Transvaginal ultrasound (TVS) is a primary imaging modality in evaluating endometrial abnormalities.
• Accurate preoperative prediction of high-risk endometrial cancer can optimize patient management.

Purpose of the Study:

• To develop and evaluate a scoring system using TVS to predict high-risk endometrial cancer.
• To assess the performance of the developed score in differentiating between low- and high-risk disease.
• To determine the utility of the score in preoperative work-up.

Main Methods:

• A consecutive cohort of 266 patients with endometrial cancer or atypical hyperplasia underwent preoperative TVS.
• Clinical parameters, endometrial morphology, and Doppler scores were recorded.
• Multivariate logistic regression was used to develop the High-Risk Endometrial Cancer (HIREC) score based on age, Doppler score, and endometrial thickness (ET).

Main Results:

• The HIREC score, incorporating age, Doppler score, and ET, demonstrated an AUC of 78.5% for predicting high-risk cancer.
• A HIREC score ≥7 predicted high-risk endometrial cancer with 72.7% sensitivity and 88.4% specificity.
• Low-risk endometrial cancer was predicted with 91.4% sensitivity and 46.4% specificity at HIREC scores <5.

Conclusions:

• The HIREC scoring system effectively differentiates between low- and high-risk endometrial cancer.
• This simple point system is suitable for initial ultrasound assessments and preoperative planning.
• Further validation studies are recommended to confirm the HIREC score's clinical utility.