Pre-operative sonohysterographic assessment of myometrial invasion in endometrial cancer patients

Introduction: Pre-operative knowledge of the myometrial invasion may be of help in distinguishing pre-operatively low risk patients in whom the pelvic lymphadenectomy might be avoided. The aim of this study has been to evaluate the accuracy of sonohysterography in predicting pre-operatively the myometrial invasion of the endometrial cancer. Materials and Methods: Thirty sonohysterographies were performed in order to evaluate the myometrial invasion of already diagnosed endometrial cancers. Results have been compared with final histological examination. Accuracy, sensitivity and specificity have been calculated. Results: Accuracy, sensitivity and specificity in predicting the myometrial infiltration were 93.3%, 92.6% and 100% respectively. Accuracy, sensitivity and specificity in predicting the depth of the myometrial infiltration were 88%, 77.8% and 93.7% respectively. Conclusions: The sonohysterography is very accurate in predicting both the myometrial invasion and its depth. In our study the sonohysterography has not been able to predict either the cervical involvement or the presence of extrauterine disease. The pre-operative sonohysterographic assessment of the extension of the endometrial cancer is reliable only as far as the prediction of the myometrial infiltration is concerned.