Can dynamic contrast-enhanced ultrasound (DCE-US) improve diagnostic performance in endometrial cancer staging? A proof of concept.

Can dynamic contrast-enhanced ultrasound (DCE-US) improve diagnostic performance in endometrial cancer staging? A proof of concept. Ultrasound Obstet Gynecol. 2019 Oct 24;: Authors: Green RW, Epstein E Abstract OBJECTIVE: To compare the sensitivity and specificity of conventional two-dimensional transvaginal ultrasound/power Doppler (2D-TVU/PD) alone to 2D-TVU/PD combined with dynamic contrast-enhanced ultrasound (DCE-US) in diagnosing deep myometrial invasion (MI) and cervical stromal invasion (CSI) in women with endometrial cancer (EC) and to correlate DCE-US and 2D-TVU/PD quantitative and qualitative variables to FIGO stage ≥IB and to 'high' risk cancer (stage ≥IB and/or grade 3 endometrioid and/or non-endometrioid histology). METHODS: A prospective study including 101 consecutive women with biopsy-confirmed EC, undergoing expert ultrasound examination at Karolinska University Hospital, Stockholm, Sweden, a tertiary referral center. All consenting women underwent DCE-US (using a 1.5-2.5 ml intravenous bolus of Sonovue® contrast agent) and conventional 2D-TVU/PD examination. DCE-US video clips were analyzed with regard to filling pattern, wash-in pattern and wash-out pattern and semi-quantitative DCE-US parameters (wash-in slope, time-to-peak, peak intensity and area-under-the-time-intensity-curve) obtained from a time-intensity curve. The study cohort was compared to a control cohort examined with 2D-TVU/PD only, matched 3:1 on FIGO sta...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research

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CONCLUSIONS: In the hands of experienced ultrasound examiners SA was superior to taking measurements for prediction of deep MI and CSI of endometrial cancer especially in grade 1-2 tumors. The mathematical models for prediction of high-risk cancer performed as expected. The best strategy to predict high-risk endometrial cancer was either to simply combine SA with biopsy grade or to use the subjective 2-step strategy, both having an accuracy of 80%. This article is protected by copyright. All rights reserved. PMID: 31225683 [PubMed - as supplied by publisher]
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
We report a case of misdiagnosed endometrial cancer by D&C, but with a positive cytopathological finding. Following that, a meta-analysis including 4,179 patients of endometrial diseases with cyto-histopathological results was performed to assess the value of the endometrial cytological method in endometrial cancer diagnosis. The pooled sensitivity and specificity of the cytological method in detecting endometrial atypical hyperplasia or cancer was 0.91[95% confidence interval (CI) 0.74–0.97] and 0.96 (95% CI 0.90–0.99), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 25.4 (...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Vit Weinberger1, Marketa Bednarikova2, Jitka Hausnerova3, Petra Ovesna4, Petra Vinklerova1, Lubos Minar1, Michal Felsinger1, Eva Jandakova3, Marta Cihalova3 and Michal Zikan5* 1Department of Gynecology and Obstetrics, University Hospital in Brno and Masaryk University, Brno, Czechia2Department of Internal Medicine – Hematology and Oncology, University Hospital in Brno and Masaryk University, Brno, Czechia3Department of Pathology, University Hospital in Brno and Masaryk University, Brno, Czechia4Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czechia5Institute of Biostati...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres. PMID: 30029961 [PubMed - as supplied by publisher]
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
The most common cancer of the reproductive organs in American women is endometrial cancer. The American Cancer Society estimates that for the year 2017, around 61,380 new cases of cancer of the body of the uterus will be diagnosed and about 10,920 women will die from cancers of the uterine body. These figures include both endometrial cancers and uterine sarcomas. Since endometrial cancer is a fairly common cancer in women, the more women know the facts about this disease, the greater their chance of knowing what symptoms to be aware of in order to have it diagnosed as early as possible, improving the likelihood of surviva...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
In this study 45 women diagnosed with stage I endometrial carcinoma were categorized into three groups: group I, group II, and group III. In group I, 15 patients were injected with 1% methylene blue into the subserosal myometrium at eight injection sites: the most superior portion of the anterior midline and posterior midline of the fundus, the anterior and posterior midpart of the uterus, the anterior and posterior lower part of the uterus, and lastly at both corneal ends. In group II, 15 patients were injected with 1% methylene blue into the cervicosubserosal myometrium at four injection sites: in 12, 3, 6, and 9 o&rsquo...
Source: Journal of Evidence-Based Womens Health Journal Society - Category: OBGYN Tags: Original articles Source Type: research
Conclusions: The suggested conservative treatment strategy can be considered as a valid therapeutic option for young women of childbearing potential with atypical endometrial hyperplasia and grade 1 endometrial adenocarcinoma who wish to preserve their fertility and thus may be recommended as an alternative to hysterectomy. Close follow-up during and after the treatment period is strictly required.
Source: International Journal of Gynecological Cancer - Category: Cancer & Oncology Tags: Uterine Cancer Source Type: research
The other night, I sat in a restaurant with a group of girlfriends. We shared laughter, good conversation and some great wine. As I looked around, I realized that we were likely to share something else: uterine fibroids. Of the ten women sitting at the table, there was a good chance that seven of us would have uterine fibroids at some point in our lives. Fibroids are noncancerous tumors that grow in the uterus. They may be smaller than a seed or bigger than a grapefruit. A woman may have only one fibroid or she may have many. Depending on their size, number, and location, fibroids can cause heavy bleeding and long menstrua...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Women's Health fibroids uterine fibroids Source Type: news
ABSTRACT ObjectivesTo assess interobserver reproducibility among ultrasound experts and gynecologists in the prediction by transvaginal ultrasound of deep myometrial and cervical stromal invasion in women with endometrial cancer. MethodsSonographic videoclips of the uterine corpus and cervix of 53 women with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated into a digitalized survey. Nine ultrasound experts and nine gynecologists evaluated presence or absence of deep myometrial and cervical stromal invasion. Histopathology from hysterectomy specimens was used as the gold standard. R...
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Original Paper Source Type: research
CONCLUSIONS: The overall incidence of lymphocele development after lymphadenectomy for gynecological cancer remains high. However the majority of lymphoceles are only incidental finding without clinical impact. A symptomatic lymphocele is an uncommon event, occurring in only 5.8% of patients. Symptomatic lymphoceles tend to develop earlier than asymptomatic. Although such risk factors are hard to avoid, patients known to be at an increased risk of developing symptomatic lymphoceles can be counselled appropriately and followed-up for specific symptoms relating to lymphocele development. PMID: 25720294 [PubMed - as supplied by publisher]
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
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