Endometrial cancer: preoperative evaluation of myometrial infiltration magnetic resonance imaging versus transvaginal ultrasonography

From January 1996 to December 1998, 33 patients with endometrial carcinoma were preoperatively examined in our department; 30 women underwent transvag inal ultrasonography (TVUS) and magnetic resonance imaging (MRI), and 3 onl y TVUS. Diagnosis was obtained by histopathological examination of the tissue remov ed by hysteroscopically controlled biopsy or by curettage of the uterine ca vity. TVUS and MRI were performed a few days before surgery. After surgery the uterus was histopathologically examined by a pathologist in order to evaluate the depth of myometrial invasion. The results were com pared with TVUS and MRI data to determine sensibility and specificity, posi tive predictive value (PPV) and negative predictive value (NPV) of the two methods. According to the results of the present study we conclude that: - TVUS is a low cost, easily performed and reliable method in a high percen tage of cases if carried out by a skilled ecographist. - MRI, is more expensive and has a lower specificity and sensibility index; it is a valid method if the cervical canal is involved and/or myometrial i nvasion is > 50% (M2) and if lymphatic invasion has to be investigated.