Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study

E Epstein, D Fischerova, L Valentin, A C Testa, D Franchi, P Sladkevicius, F Frühauf, P G Lindqvist, F Mascilini, R Fruscio, L A Haak, G Opolskiene, M A Pascual, J L Alcazar, V Chiappa, S Guerriero, J W Carlson, C Van Holsbeke, F P G Leone, B De MoorT Bourne, B van Calster, A Installe, D Timmerman, J Y Verbakel, T Van den Bosch

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.

METHODS: This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.

RESULTS: In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m2 , 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%).

CONCLUSION: Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Original languageEnglish
Pages (from-to)818-828
Number of pages11
JournalUltrasound in Obstetrics and Gynecology
Volume51
Issue number6
DOIs
Publication statusPublished - Jun 2018

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Endometrial Neoplasms
Terminology
Multicenter Studies
Prospective Studies
Neoplasms
Color
Doppler Ultrasonography
Uterine Hemorrhage
Hysterectomy
Nuclear Family
Body Mass Index
Logistic Models
Databases
Biopsy
Equipment and Supplies

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Consensus Development Conferences as Topic
  • Cross-Sectional Studies
  • Endometrial Neoplasms/classification
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Prospective Studies
  • Reproducibility of Results
  • Terminology as Topic
  • Ultrasonography, Doppler, Color/standards

Cite this

Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature : prospective multicenter study. / Epstein, E; Fischerova, D; Valentin, L; Testa, A C; Franchi, D; Sladkevicius, P; Frühauf, F; Lindqvist, P G; Mascilini, F; Fruscio, R; Haak, L A; Opolskiene, G; Pascual, M A; Alcazar, J L; Chiappa, V; Guerriero, S; Carlson, J W; Van Holsbeke, C; Leone, F P G; De Moor, B; Bourne, T; van Calster, B; Installe, A; Timmerman, D; Verbakel, J Y; Van den Bosch, T.

In: Ultrasound in Obstetrics and Gynecology, Vol. 51, No. 6, 06.2018, p. 818-828.

Research output: Contribution to journalArticle

Epstein, E, Fischerova, D, Valentin, L, Testa, AC, Franchi, D, Sladkevicius, P, Frühauf, F, Lindqvist, PG, Mascilini, F, Fruscio, R, Haak, LA, Opolskiene, G, Pascual, MA, Alcazar, JL, Chiappa, V, Guerriero, S, Carlson, JW, Van Holsbeke, C, Leone, FPG, De Moor, B, Bourne, T, van Calster, B, Installe, A, Timmerman, D, Verbakel, JY & Van den Bosch, T 2018, 'Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study', Ultrasound in Obstetrics and Gynecology, vol. 51, no. 6, pp. 818-828. https://doi.org/10.1002/uog.18909
Epstein, E ; Fischerova, D ; Valentin, L ; Testa, A C ; Franchi, D ; Sladkevicius, P ; Frühauf, F ; Lindqvist, P G ; Mascilini, F ; Fruscio, R ; Haak, L A ; Opolskiene, G ; Pascual, M A ; Alcazar, J L ; Chiappa, V ; Guerriero, S ; Carlson, J W ; Van Holsbeke, C ; Leone, F P G ; De Moor, B ; Bourne, T ; van Calster, B ; Installe, A ; Timmerman, D ; Verbakel, J Y ; Van den Bosch, T. / Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature : prospective multicenter study. In: Ultrasound in Obstetrics and Gynecology. 2018 ; Vol. 51, No. 6. pp. 818-828.
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abstract = "OBJECTIVE: To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.METHODS: This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.RESULTS: In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m2 , 1377 (89.5{\%}) women were postmenopausal and 1296 (84.3{\%}) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23{\%}; 95{\%} CI, -27 to -18{\%}), were larger (mean endometrial thickness; difference of +9{\%}; 95{\%} CI, +8 to +11{\%}), and were more likely to have non-uniform echogenicity (difference of +7{\%}; 95{\%} CI, +1 to +13{\%}), a multiple, multifocal vessel pattern (difference of +21{\%}; 95{\%} CI, +16 to +26{\%}) and a moderate or high color score (difference of +22{\%}; 95{\%} CI, +18 to +27{\%}).CONCLUSION: Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright {\circledC} 2017 ISUOG. Published by John Wiley & Sons Ltd.",
keywords = "Adult, Aged, Aged, 80 and over, Consensus Development Conferences as Topic, Cross-Sectional Studies, Endometrial Neoplasms/classification, Female, Humans, Middle Aged, Neoplasm Grading, Prospective Studies, Reproducibility of Results, Terminology as Topic, Ultrasonography, Doppler, Color/standards",
author = "E Epstein and D Fischerova and L Valentin and Testa, {A C} and D Franchi and P Sladkevicius and F Fr{\"u}hauf and Lindqvist, {P G} and F Mascilini and R Fruscio and Haak, {L A} and G Opolskiene and Pascual, {M A} and Alcazar, {J L} and V Chiappa and S Guerriero and Carlson, {J W} and {Van Holsbeke}, C and Leone, {F P G} and {De Moor}, B and T Bourne and {van Calster}, B and A Installe and D Timmerman and Verbakel, {J Y} and {Van den Bosch}, T",
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TY - JOUR

T1 - Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature

T2 - prospective multicenter study

AU - Epstein, E

AU - Fischerova, D

AU - Valentin, L

AU - Testa, A C

AU - Franchi, D

AU - Sladkevicius, P

AU - Frühauf, F

AU - Lindqvist, P G

AU - Mascilini, F

AU - Fruscio, R

AU - Haak, L A

AU - Opolskiene, G

AU - Pascual, M A

AU - Alcazar, J L

AU - Chiappa, V

AU - Guerriero, S

AU - Carlson, J W

AU - Van Holsbeke, C

AU - Leone, F P G

AU - De Moor, B

AU - Bourne, T

AU - van Calster, B

AU - Installe, A

AU - Timmerman, D

AU - Verbakel, J Y

AU - Van den Bosch, T

N1 - Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

PY - 2018/6

Y1 - 2018/6

N2 - OBJECTIVE: To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.METHODS: This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.RESULTS: In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m2 , 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%).CONCLUSION: Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

AB - OBJECTIVE: To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.METHODS: This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.RESULTS: In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m2 , 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%).CONCLUSION: Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Consensus Development Conferences as Topic

KW - Cross-Sectional Studies

KW - Endometrial Neoplasms/classification

KW - Female

KW - Humans

KW - Middle Aged

KW - Neoplasm Grading

KW - Prospective Studies

KW - Reproducibility of Results

KW - Terminology as Topic

KW - Ultrasonography, Doppler, Color/standards

U2 - 10.1002/uog.18909

DO - 10.1002/uog.18909

M3 - Article

C2 - 28944985

VL - 51

SP - 818

EP - 828

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 6

ER -